What you need to know about Egypt’s universal health insurance law?

CAIRO – 19 December 2017: Minister of Health and Population Ahmed Emad Eddin Rady announced the approval of the Council of Representatives on all articles of the new comprehensive universal health insurance law after fruitful discussions.

The minister praised the role of Members of the Parliament's Health Committee and their keenness to complete the bill and approve it quickly.

The new bill is considered to be the first health system covering all citizens, providing services that suit all citizens in accordance with international quality standards.
The announcement took place while Rady and Minister of Finance Amr Al-Garhy were attending the parliament's discussions. Ali Hegazi, Assistant Minister of Health for Health Insurance Affairs, and Mohammed Moait, Deputy Minister of Finance for Public Treasury Affairs, were also present and attended the session. The Parliament agreed on the 67-article bill after introducing amendments suggested by MPs, as well as health experts.

On his turn, the Minister of Health and Population congratulated the Egyptian people for the final approval of the comprehensive universal health insurance bill by the House of Representatives. The bill passed by an unprecedented parliamentary majority, after a two-day plenary session.

The new health insurance system will be first applied in five governorates; they are Port Said, Suez, Ismailia, North Sinai and South Sinai – to be generalized across the country within the coming years. “The system will be applied gradually between 2018 [and] 2032,” said Khaled Megahed, the official spokesman to ministry of health and population. He added that currently around 42 million citizens do not benefit from any health insurance services.

The new system will be funded through the taxes imposed on cigarettes and tobacco, along with other items and other funding sources. “The new program will be introduced with high efficiency. It will also end the high cost of medical services provided by the private sector,” explained Megahed.

All private hospitals will have to adhere to the prices set by the government. The bill was drafted by 22 health insurance officials, bankers, and academic physicians. It has been worked on for the past six years.

The new universal health insurance law stipulates that the government will fully cover health expenses for those who are unable to pay for their medical treatment, about 30 percent of Egypt's population, Megahed said.

Amongst the most important articles which were approved by the parliament are the following.

Article (40) deals with the sources of funding of the Authority. Megahed pointed out that article includes 9 points, all of which are concerned with the Authority's resources. It is also concerned with the collection of funds from other sources in order to finance the system, including P.T. 75 of the value of each pack of cigarettes sold in the domestic market, whether local or foreign, to be increased every three years by P.T. 25, plus LE 1 toll for each vehicle passing highways and LE 20 for each year when issuing or renewing the driving license. Also, LE 50 when issuing or renewing the license cars with a capacity of less than 1,600 CC and LE 150 for cars with a capacity of less than 2,000 CC and LE 300 for cars with a capacity exceeding 2,000 CC.

This comes in addition to LE 1,000 collected for each bed when issuing licenses of new hospitals and medical centers, LE 20 of the value of each ton of cement produced locally or abroad and LE 50 for every ton of iron manufactured locally or abroad. When opening new clinics and pharmacies, owners are to pay an amount ranging between LE 1,000 and LE 15,000 depending on several criteria.

The Minister of Health stated that ministry of social solidarity is committed to paying the value of the health insurance for unemployed persons eligible for unemployment compensation in accordance with the provisions of the Social Security regulations. The ministry is also committed to collect the contributions of health insurance due from different parties.

Article (42) states in the case of a delay in payment of contributions, an additional annual amount shall be imposed on the individual as a fine for the delay period. The additional amount shall be calculated in accordance with the rules provided for in the Civil Code.

According to Article (44), the financial status of the system shall be examined at least once every four years by one or more experts in the field of health who shall be assigned by the Prime Minister based on the nomination of the Minister of Finance and Minister of health.

Article (48) stipulates that the use of comprehensive social health insurance services requires that the beneficiary be a participant in the system and is paying their share. Individuals who do not join the universal health insurance from the beginning but decide to do so later will be obliged to pay the arrears via a one-off payment or in installments, except in case of an emergency, as defined by the authority.

Article (49) states that those insured shall bear their share and the employer's share during the duration of the internal or external loan and the unpaid special leave and shall be handed directly to the Authority except for childcare leave, scholarships, sabbatical leave and scientific assignments granted to the administrative units of the State.

Article (52) specifies that the bodies established under this law shall have an independent budget and shall begin their financial year at the beginning of the fiscal year of the State and shall end by the end of each year.

Article (53) determines that the provisions of the Law shall be suspended during the period of compulsory conscription, retention and summoning of the armed forces.
Article (59) determines that the Authority may provide its services to foreign residents or in accordance with the regulations it establishes, taking into consideration the requirement of reciprocity.

Article (62) stipulates that a penalty of imprisonment for a period of not less than six months and a fine of not less than LE 2,000 and not more than LE 10,000, or one of these penalties, shall be given to anyone who gives incorrect statements or refrained from giving the data provided for in this law. Not less than six months and a fine of not less than LE 20,000 and not exceeding LE 100,000, or one of these penalties, to any individual or group that hinders the work of employees of the Commission who are eligible to apply judicial seizure.

Article (63) asserts that a penalty of not less than one year and a fine of not less than LE 50,000 and not more than LE 70,000, or one of these two penalties, shall be imposed on each employee of the Authority who would illegally facilitate the attainment of medication or compensatory equipment. In such cases, the court shall confiscate medicine or compensatory devices, or its value, in favor of the Authority.

Somewhat similar to Article (63), Article (65) affirms that a penalty of imprisonment for a period of not less than six months and a fine of not less than LE 100,000 and not exceeding LE 200,000, or one of these penalties, for each employee of the Authority or service provider who shall assist any participant from not paying his share to the authority.