After two days of heated discussion, Egypt's parliament finally approved with a two-thirds majority a government-drafted law on national health insurance on Monday. Minister of Health Ahmed Emadeddin said "the day parliament approved this law should be considered a historic day." "In December 2015, Minister of Finance [Amr El-Garhy] and I received orders from President Abdel-Fattah El-Sisi to draft a law that should pave the way for implementing a comprehensive national health insurance law in Egypt," Emadeddin said, adding that "today is a historic day as we were able to get the approval of MPs on this landmark law." "This law was heavily discussed in order to ensure that there will be sufficient funding for the new national health insurance system," Emadeddin said, adding that "the subscription and membership fees of this system could be a little bit high, but this is important in order to guarantee that it will be sustainable and will not collapse due to any abrupt lack of funding." Finance minister El-Garhy told MPs that "in drafting the law, the ministries of health and finance reviewed 31 scenarios for funding, and in the end we reached the scenario that we think best guarantees that the system will be effectively implemented and that as many citizens as possible will be covered." El-Garhy said the law will cover around 40 percent of the population. The law will be implemented over a maximum of 15 years, beginning next year with the governorate of Port Said. Parliament speaker Ali Abdel-Aal said the law was revised in constitutional and legal terms by the State Council. "Parliament gave top priority to this law as the constitution stipulates that a new comprehensive national health insurance system should be in place in Egypt as soon as possible," Abdel-Aal said. There was stormy debate on Article 40, which details the sources of funding necessary to cover the new health insurance system and ensure that it performs in an efficient and sustainable way. Many MPs, especially leftists, tried their best to lower subscription and membership fees necessary to access the system. "It is so sorrowful that this comes at a time when citizens are still suffering from high inflation rates and hard living conditions," said leftist MP Haitham El-Hariri, adding that he has strong fears that the law will eventually lead to privatising public hospitals. In response, Minister of Health Emadeddin insisted that "the subscription fees should be high in order for the system to be sustainable and not collapse." Parliament speaker Abdel-Aal insisted that "a free national health insurance system would be a big failure." "Egypt is no longer a socialist country mobilised to provide free health and education services," Abdel-Aal said, adding that "the subscription fees may be high in the beginning, but they will be affordable with the system gradually covering the entire country." Article 40 states that there will be nine sources of funding for the new national health insurance system. These include subscription fees, budgetary allocations, foreign and local donations and loans, contributions, and other sources such as cigarette, food and drug sales. "[Funding] will also come from cement and iron sales and from fees imposed on citizens when renewing driving licences and identity cards," Article 40 reads. Under the law, three organisations – the Healthcare Organisation, the Quality and Authorisation Authority, and the National Health Insurance Organisation – will be responsible for implementing national health insurance. The three organisations will have the power to ensure that the national health insurance system is strictly implemented, and can take the necessary legal procedures to ensure that public and private businesses pay the required subscription fees.
