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Israeli Prime Minister Benjamin Netanyahu and Director General of the Ministry of Health Moshe Bar Siman-Tov hold a press conference about the coronavirus COVID-19, at the Ministry of Health in Jerusalem, on March 4, 2020. (Olivier Fitoussi/Flash90)
Olivier Fitoussi/Flash90, shows Prime Minister Benjamin Netanyahu and Director General of the Ministry of Health Moshe Bar Siman-Tov avoiding handshakes at a press conference about the coronavirus COVID-19, at the Ministry of Health in Jerusalem, on March 4, 2020
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Meet ‘Barsi,’ the ruthless economist directing Israel’s drastic virus fight

Moshe Bar Siman-Tov, 43, the first non-doctor to lead the Health Ministry, is bucking withering criticism with a strategy aimed to prevent coronavirus from overwhelming hospitals

Haviv Rettig Gur is The Times of Israel's senior analyst.

Main image by Olivier Fitoussi/Flash90, shows Prime Minister Benjamin Netanyahu and Director General of the Ministry of Health Moshe Bar Siman-Tov avoiding handshakes at a press conference about the coronavirus COVID-19, at the Ministry of Health in Jerusalem, on March 4, 2020

His friends and colleagues call him “Barsi,” an unassuming nickname for an unassuming man, the sort of man who likes to wear gray sports coats over gray shirts. But don’t be fooled by his mild manners and soft-spoken air. Moshe Bar Siman-Tov, Israel’s point man in the fight to slow the spread of the coronavirus, is considered among the most ruthless and competent managers in the Israeli state bureaucracy. His professional story, like his handling of the coronavirus crisis, tells a tale that reveals much about the Jewish state’s resilience and success over the years — and, perhaps, its overreliance on powerful bureaucrats.

Bar Siman-Tov, 43, is the first non-doctor to ever hold the post of director general of Israel’s Health Ministry, the nation’s top public health professional. He is, rather, an economist, and a special kind of economist at that. “Barsi” is a member and a symbol of a small subsection of Israeli officialdom dubbed “the Treasury youths” by the rest of the state bureaucracy.

These “youths” are teams of young economists in their 20s and 30s toiling over charts and figures in the Finance Ministry’s Budgets Department. It is hard to exaggerate their oversize influence, or their oversize sense of self. The Budgets Department, charged with planning and tracking the state budget, calls itself the “commando unit of the public service.” It believes that it alone stands in the breach protecting the nation from the catastrophic effects of runaway deficits, that it alone protects the public’s fiscal interests when everyone else – politicians, activists, even the public itself – conspires to set the nation down the path of a Greece or a Venezuela.

In 2015, when he became the first non-doctor to lead the Health Ministry, the Israel Medical Association appealed to the High Court of Justice against the appointment, contending that his lack of medical expertise made him egregiously unfit for the job

Bar Siman-Tov was raised in a religious home but is now secular. Yet he possesses an almost religious faith in the vital role that hard-nosed economists can and must play in the public sector, making the tough but responsible choices that politicians and interest groups often will not. It is a faith he shares with other “Treasury youths” (he once protested he’s “not so young anymore” when a reporter used the phrase to his face) and with the professional planning echelons of other government agencies.

In 2015, when he became the first non-doctor to lead the Health Ministry, the Israel Medical Association appealed to the High Court of Justice against the appointment, contending that his lack of medical expertise made him egregiously unfit for the job. The government responded with its view that an economist was not less suited to manage the health system than a physician.

The court took the government’s side and let the appointment stand. But even as he declined to intervene, Justice Elyakim Rubinstein wrote of his “hope that the experiment succeeds… and the health system and the public all benefit from the skills the new director general possesses in the fields of health economics and regulation.”

Health Ministry Director General Moshe Bar Siman-Tov attends a press conference about the coronavirus, at the Prime Minister’s office in Jerusalem on March 8, 2020. (Yonatan Sindel/Flash90)

One thing is certain: Bar Siman-Tov’s direct bosses, Health Minister Yaakov Litzman and Prime Minister Benjamin Netanyahu, believe the experiment has been wildly successful, and have shown they are willing to take drastic and unpopular steps at Bar Siman-Tov’s urging. He, in turn, is famous in the halls of government for vigorously backing subordinates who catch flak for decisions that are unpopular but, he believes, correct.

He represents, then, a kind of apotheosis of the influential Israeli bureaucrat, a stratum of government that many believe deserves a great deal of credit for Israel’s astounding achievements and strengths, but that raises concerns over its overwhelming influence on decisionmaking.

Coronavirus: protection and suffering

Israel’s early and vigorous response to the coronavirus outbreak was deemed extreme by many observers. It raised hackles in Beijing, Seoul and Rome as their nationals were suddenly, and sometimes without warning, turned back at the airport. Israel did more to limit travel from more countries, and did it faster, than any other nation on Earth. By early March, as the scale of the threat grew and governments in Italy and the US were coming under criticism for doing too little, some of the anger at Bar Siman-Tov’s quarantines and air travel restrictions lessened.

“Barsi” led an aggressive effort to slow the virus’s penetration into Israel — not because he thought he could stop it, but because slowing its spread would prevent overtaxing Israel’s hospitals and health infrastructures. The thinking was sound, health experts said. Israel only has so many respirators and lung specialists, making the death toll from the virus a function not of the number of people who fall ill, but of the rate at which they do so.

If the number of ill at any given time could be kept at levels that Israel’s health infrastructure could accommodate, far more would survive infection. Slowing the spread could mean the difference between a few hundred dead by the end of the crisis and many thousands or even more who succumb because hospitals could not treat them properly and ventilators were in short supply.

It was an unusually effective response to a public health crisis, and some have already suggested that the fact that a government economist was in charge – an economist trained not only to discern trends, but to act quickly and decisively on them – made all the difference.

A tourist wearing a face mask for protection from the coronavirus at the Western Wall in the Old City of Jerusalem on March 5, 2020. (Olivier Fitoussi/Flash90)

Yet that rosy picture of decisiveness and competence is only a small part of the story. The government’s decisions over the past month have sparked a great deal of fear and real suffering.

As Histadrut labor federation chief Arnon Bar-David put it in a Tuesday press conference, “We’re on the verge of a ‘Yom Kippur’ [Day of Atonement] for the entire Israeli economy. I fear for the fate of our economy and our society.”

Several industries that depend on international travel and large gatherings of people – hotels, tour companies, private bus companies, event halls, airlines, conference organizers, caterers – are being devastated by the sudden disappearance of most of their business for the immediately foreseeable future

Bar-David’s dramatic rhetoric reflects a palpable concern among Israelis as hundreds of thousands start to feel the sting of the economic fallout from the Health Ministry’s draconian steps.

Several industries that depend on international travel and large gatherings of people – hotels, tour companies, private bus companies, event halls, airlines, conference organizers, caterers – are being devastated by the sudden disappearance of most of their business for the immediately foreseeable future.

The Ramon Airport in the south announced a grim triage last week, firing childless workers first and trying to hold on to those with families to feed as flights stopped arriving and revenue dried up. It was an unhappy signal that management had no idea when it might be in a position to rehire the lost staffers.

Tour companies up and down the country put their tour guides on unpaid leave for the coming months. Airlines changed their pilots’ salary scheme from a monthly wage to an hourly one, including for senior pilots. Pilots then watched as flight schedules dried up and the available hours vanished.

The near-empty departure halls of Ben Gurion Airport on March 8, 2020. (Flash90)

On Monday, the potential economic pain ratcheted up dramatically as Israel announced a 14-day quarantine for all international travelers from everywhere, ensuring that pain would spread to all corners of the economy. While Bar Siman-Tov may have started that expansion, demanding a quarantine for visitors from the US, or at least from parts of the US experiencing viral outbreaks, it is not yet clear what drove the government to apply the quarantine to all parts of the world. Hebrew media reports suggested on Tuesday that it followed American pressure, with US Vice President Mike Pence reportedly asking Netanyahu not to declare a quarantine that singles out America.

Whatever the case may be, the virus, and Israel’s response to it, has already disrupted the country’s access to global supply chains, as a significant proportion of imports had arrived in Israel on the now-canceled passenger flights. Suddenly lumber yards can’t get new lumber. Even many tech companies are now firing engineers because they can no longer acquire components for their products from abroad. Nor is the religious realm immune to the disruption, with clergy and religious institutions losing a vital source of usually stable income as pilgrimages and bar mitzvah trips dry up.

Israelis may not be panicking, but families throughout the country are coming to terms with the prospect of painful and uncertain times ahead. From minimum-wage cleaning staff to top-paid pilots, every decile of the Israeli economy will feel the belt-tightening – with some deciles far less able to cope or bounce back than others.

Enjoying the dilemmas

Bar Siman-Tov’s rise in the bureaucracy was meteoric. He was just in his mid-twenties and not even finished with his BA at the Hebrew University of Jerusalem when he got his first job on the labor and welfare team of the Budgets Department. Five years later, in 2006 and still only 30 years old, he was appointed lead coordinator of the welfare planning team in the National Insurance Institute – the nation’s main disburser of welfare grants. Two years later he was running NII’s health budget team, and two years after that returned to the Finance Ministry as the deputy head of the Budgets Department in charge of the social budgets, including health, welfare and education.

He was one of the more successful examples of the “Treasury youth,” but not unusually so. That coterie of officials are groomed for leadership and often assigned to planning staffs outside the department in a bid to bring the department’s culture of long-term economic planning – and, some say, to expand the department’s own influence – to other agencies of government.

In 2011, after Bar Siman-Tov led the Treasury team negotiating with the Israel Medical Association a new national pay structure for physicians in public hospitals, he gave a rare personal interview to the business journal Globes.

Parents of children from the Hema-ontology department in Hadassah Ein Kerem yell at Health Ministry Director General Moshe Bar Siman-Tov at the Supreme Court in Jerusalem on June 27, 2017, after a court hearing on the troubled department. (Yonatan Sindel/Flash90)

The negotiations had been fierce. Israel Medical Association head Leonid Edelman had gone on a hunger strike, and accusations from various parties in the talks accused Bar Siman-Tov of causing irreparable harm to Israel’s health system.

It was in that moment that Bar Siman-Tov told Globes in September 2011 that he “enjoys” his job.

“I won’t apologize for the fact that I enjoy my job. It’s fun not because I might have to step on people, but because I’m in the arena,” he said. “My job [as head of social budgets in the Budgets Department at the time] is considered the least attractive among all the deputies in the department, because I’m not paving roads and not bringing new operators into the cellular market. I’m doing things that are the building blocks of any society. But every decision like this has a cost. You’re always in a dilemma, in a conflict, because there’s no right or wrong [decision] on the social [budgets] team. The complexity of these issues is fundamental to them, and I thrive in these dilemmas.”

He is both a product and an evangelist of the Budgets Department’s culture of hard-nosed economic planning, and forms part of an extraordinarily influential professional echelon across many agencies of government — the army, the Prime Minister’s Office, the Interior Ministry, the National Security Council, to name a few — that is generally viewed as a key instrument of Israel’s resilience and policy smarts.

That culture, more than any other factor, can help explain how Israel was capable of pursuing such a radical response to the coronavirus threat, and implementing it despite vociferous opposition from major corporations, influential labor unions and some senior politicians.

Moments of crisis can be revealing. Some critics have charged that Israel’s overwrought response to the outbreak was driven by Israeli politicians’ electioneering needs. But one look at the situation in the US or Italy suggests that the political class, left to its own devices, would probably have preferred a more lax and less economically disruptive approach.

Any attempt to understand Israel’s response to crises such as the current one must take into account the power, influence and culture of the state’s self-assured and powerful civil service. Simultaneously trusted and disliked by the country’s political class, Israel’s bureaucrats have proven themselves adept at delivering decisive action in a crisis.

Time will tell if Bar Siman-Tov’s far-reaching and forceful measures will be vindicated by events, and come to be envied by other countries worldwide — or turn out to have caused radically unnecessary damage, raising new questions about the country’s assertive state bureaucracy.

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