The healing of Egypt: A new universal health insurance law

Reem Leila , Saturday 17 Feb 2018

A state-of-the-art health insurance scheme has been approved with the aim of guaranteeing the provision of optimal healthcare to all Egyptians

Hepatitis C test
Egyptian workers line up for a Hepatitis C test at a construction site near Cairo on August 3, 2017 (Photo: AFP)

Egypt has a health insurance system that dates to the 1960s, when populist policies extended basic services to all citizens.

The 1962 law stipulated that everyone would be covered by the health insurance, but over the years it lost its effectiveness, pushing many to forego the system in search of better quality healthcare.

With the old insurance system deemed hopeless, there have been many attempts to come up with a better universal plan for health insurance and to ensure that everyone is covered by medical insurance.

Finally, this year a high-profile plan to improve health-insurance coverage for the public was approved by the House of Representatives, the country’s parliament. The law is designed to provide optimal medical services for the whole nation.

All public and private-sector workers will benefit from the new comprehensive insurance system, along with their wives, parents and children. Premiums will be taken from monthly salaries at varying percentages, though always less than five per cent.

The new insurance law will be applied over three phases, starting this year and ending in 2032. It will be introduced first in Port Said, Suez, Ismailia, North Sinai, South Sinai and Alexandria.

The second phase includes the governorates of Fayoum, Beni Sueif, Assiut, Minya, Sohag, Qena, Luxor, Aswan, the New Valley and the Red Sea. The final phase will include Cairo, Giza, Qaliubiya, Beheira, Gharbiya, Menoufiya, Kafr El-Sheikh, Sharqiya, Daqahliya, Damietta and Marsa Matrouh.

The new insurance law is supposed to enhance health coverage for all, with the rich shouldering a larger part of the financing. The government will fully cover the treatment of the poorest people, and those who cannot afford to pay premiums, who constitute more than 25 million people, by allocating money from the budget.

The new legislation separates financial, managerial and auditing tasks so that these no longer hinder bodies charged with providing healthcare services.

The core of the new insurance system, according to Deputy Minister of Health and Population for Insurance Affairs Ali Hegazi, is based on applying quality and cost-effective modern management techniques.

“All types of hospitals, whether private, public or even military, will be included in the new system,” Hegazi said, who added that only those which meet international quality-control standards will join the new system. Others will be excluded from the system until they amend their status.

Hegazi believes that the new insurance system will require the government to allocate at least LE120 billion annually to guarantee the system’s operating according to international standards.

“The government currently allocates only LE8 billion for the health system. Such an amount will be insufficient for the new system,” he said.

The new system will also be funded through taxes imposed on products such as cigarettes. There will be extra charges on issuing birth, death, marriage and divorce certificates. This is in addition to extra fees imposed on vehicles passing through the different governorates.

Car owners will have to pay extra sums when issuing or renewing their driving licence. Further sums will be paid when issuing or renewing licences, according to car size and capacity.

Further sources of funds include taxes ranging from between LE1,000 and LE15,000 on licences for hospitals, medical centres, clinics and pharmacies. 

Overcoming Hepatitis C:

President Abdel-Fattah Al-Sisi announced an ambitious plan to combat the Hepatitis C Virus (HCV) in 2014, and four years later it has succeeded in curing around 1.8 million patients.

Egypt has one of the highest rates of Hepatitis C infection in the world.

The Ministry of Health is exerting efforts to bring Egypt’s infection rate for HCV down to international levels by 2019, Minister of Health Ahmed Emadeddin has said.

According to a study entitled “Hepatitis C in Egypt – Past, Present and Future,” a health survey conducted in 2008 concluded that 14.7 per cent of the population had been infected, making this the highest prevalence in any population in the world.

In the Nile Delta and Upper Egypt, infection rates can be much higher at around 26 per cent and 28 per cent, respectively. This leads to an estimated 170,000 new cases every year, to add to the 11.5 million patients already suffering from the disease.

Patients are treated using the drug Sovaldi, a new HCV treatment. The medicine sells at a retail price of $84,000 per person for a 12-week course. However, it is being made available in Egypt at just $900 for a 12-week course.

“The new medicine guarantees a 98 per cent cure rate,” the health minister said. However, only patients treated within the government treatment plan enjoy the reduced prices.

“There are no waiting lists for patients suffering from HCV,” Emadeddin said. He said the ministry had increased the number of medical centres treating HCV to 163.

When President Al-Sisi came to power he instructed the Tahya Misr Fund to cover patients who could not afford the cost of the medication.

More than 150 million people around the world suffer from HCV, most of them in developing countries. In Egypt, the virus used to kill around 40,000 people per year before the introduction of the new treatment.

*This story was first published in Al-Ahram Weekly  

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