Health insurance evaluated

Gamal Essam El-Din , Sunday 21 Apr 2024

President Abdel-Fattah Al-Sisi has ordered the launch of the second phase of Egypt’s universal health insurance system.

Health insurance evaluated


Universal health insurance (UHI) aims to reform the entire healthcare system not just insurance, says Presidential Advisor for Health Affairs Mohamed Awad Taggeddin. The goal is to provide healthcare services that cover all citizens and all diseases.

On Tuesday, Tageddin said the second phase of UHI rollout will include the governorates of Damietta, Marsa Matrouh, Kafr Al-Sheikh, North Sinai, and Minya.

On Monday, Prime Minister Mustafa Madbouli and Health Minister Khaled Abdel-Ghaffar met to review preparations for implementing the second phase. Following the meeting, Abdel-Ghafaar noted that the second phase will cover 12 million citizens and that implementation will occur in parallel with the presidential Decent Life initiative which aims to improve health services in rural areas.

Implementation of the first phase, in the low population density governorates of Port Said, Suez, Ismailia, South Sinai, Aswan, and Luxor took five years to complete.

Also on Monday, the Senate discussed the problems facing the second phase rollout.

Senator Mohamed Salah Al-Badri explained that the six-phase healthcare scheme started in the governorate of Port Said in late 2019 and later expanded to Luxor and Ismailia, with lowest-income citizens given priority in the programme schedule. Over five million citizens were registered in the UHI system in the first phase, at a cost of LE51.2 billion.

“The launch of the second phase should have started at the beginning of 2024, but financial and technical problems, including a lack of infrastructure and of statistical information, caused delays,” said Al-Badri.

Ihab Abu Aish, deputy finance minister for treasury affairs, told the Senate that providing comprehensive and integrated healthcare for all Egyptians can no longer be postponed.

The UHI system covers more than 3,000 health services, including surgical operations, medical diagnostic tests, radiology scans, tumour treatments, organ transplants, and prosthetic devices.

“The services are provided by both public and private sector hospitals and medical institutes,” said Abu Aish. “Following the devaluation of the Egyptian pound the prices of medical services increased and we need to coordinate with the private sector on pricing to guarantee sustainability of the system.”

Under UHI, the private sector receives 75 per cent of costs up front and the remaining 25 per cent once the relevant paperwork is audited.

“A joint committee, including UHI and private sector representatives, constantly reviews the pricing system to reflect the change in costs of medical services offered,” said Abu Aish. He noted that the prices of medical services have changed five times since UHI came into operation.

Abu Aish underlined the urgent need to amend the UHI law’s articles regulating individual financial subscriptions. The changes will have to be endorsed by the cabinet before being sent to the House of Representatives.

Finance Minister Mohamed Maait, head of the General Authority for UHI, said earlier this year that the cost of extending health insurance to all Egyptians is more than LE360 billion.

The project dates from December 2019 when, in Port Said, President Abdel-Fattah Al-Sisi issued a directive calling for a comprehensive, high-quality national health insurance system to be established. The project was subsequently developed in close collaboration between the private sector and the government.

Earlier this month, Minister of Health and Population Khaled Abdel-Ghaffar signed four agreements with international pharmaceutical companies on behalf of Egypt’s public healthcare system.

Healthcare allocations in the new budget are set to increase by 25 per cent to reach LE496 billion, of which more than LE8 billion will go to health insurance (up 38 per cent from last year) and LE10 billion to state-funded treatments (up 25 per cent).

Ahmed Taha, head of the General Authority for Health Control and Accreditation, told the Senate that medical services under the first phase are being provided by 78 hospitals and 202 healthcare units and that “authority officials pay 100 visits a month to hospitals and units to ensure medical services comply with international standards.”

The system, added Taha, is supported by state-of-the-art automation technologies as part of the Digital Egypt Strategy, a broad national plan targeting the digitisation of all government services.

The system aims to provide quick responses to people’s complaints via a unified complaints platform. Taha said that between November 2021 and July 2022, of 499 complaints received — 187 from Luxor, 279 from Port Said, and 33 general complaints — 99 per cent had been satisfactorily resolved.

* A version of this article appears in print in the 18 April, 2024 edition of Al-Ahram Weekly

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