After a month of debates parliament's Health Committee has approved the government-drafted law on national health insurance on Saturday. Informed sources say MPs will begin discussing the draft law in a plenary session when the House of Representatives convenes on Sunday. “The long-term dream of a national health insurance system is becoming a reality,” said Minister of Health Ahmed Emadeddin after the committee approved the draft on 9 December. If parliament approves the 70-article law before the end of the year a comprehensive health insurance system could be in place within six months. Emadeddin insists funding will not be a problem and “resources are available to ensure the system delivers quality medical and health services.” Health Committee head Mohamed Al-Emary told Al-Ahram Weekly that the committee had canvassed the views of civil society organisations, the doctors, pharmacists, dentists and physiotherapists syndicates and private health service providers. El-Emary says a final draft will be ready after the plenary discussion, paving the way for “issuing a national health law which has been discussed since at least 2002, though there has, until now, been insufficient political will to push it forwards”. Magdi Morshed, secretary-general of the Support Egypt parliamentary bloc, is confident the draft will be approved by the end of this month. “A majority of MPs, the government and President Abdel-Fattah Al-Sisi are all keen to push ahead with the law,” he says. The roll-out will be gradual, beginning next year with the governorate of Port Said, and continuing till 2032 by which time the entire country will be covered. Membership of the national health insurance system will be compulsory. Port Said was chosen, says Emadeddin, because it has the lowest proportion of people below the poverty line of any governorate, lessening the initial financial burden on the government, and because its hospitals, clinics and other health services already meet the standards required by the national health insurance system. Health insurance will not cover foreigners, and hospitals affiliated with the army and police or owned by the private sector will only be allowed to participate in the system if they meet the conditions stipulated in the law, says Morshed. Under the proposed legislation three organisations — the Healthcare Organisation (HCO), the Quality and Authorisation Authority (QAA) and the Health Insurance Organisation (HIO), will be responsible for implementing national health insurance. The HCO will oversee the provision of health services, the QAA will monitor their quality while the HIO will assume financial oversight. The Health Committee spent much of its time discussing how the system would be funded and Minister of Finance Amr Al-Garhi attended many committee sessions to answer MPs' questions. He told committee members that much of the additional revenue, estimated at between LE7 billion and LE8 billion, generated by last month's increases in tobacco prices, has been earmarked for health services. Citizens will be required to pay insurance fees to access the system. “Those who refuse to pay will be excluded from a range of indispensable government services. They will not be able to renew driving licences or identity cards and, should they want to travel, will be obliged to pay any arrears before they are allowed to leave the country,” says Emadeddin. One per cent of each government employee's salary will be deducted in health insurance payments, a figure the government will top up by paying an additional four per cent, said Emadeddin. The government will also triple payments covering housewives, double those for widows and retirees, and match insurance fees for dependent children. The Health Ministry reviewed several health insurance systems operating abroad. “The new NHI law,” says Emadeddin, “is similar to that of the UK, though some tweaking was necessary to ensure it conformed with Egypt's 2014 constitution.” Emaddeddin also revealed the government had contracted an international health company to help formulate the financial system to be used in implementing the health insurance system. “The company finished its work in July after which we were able to draft the law,” he said. The new system will be radically different from existing health coverage, says Emadeddin. The current health insurance law has been in effect since 1964 and coverage is restricted to seasonal workers and government employees while “the new insurance covers all citizens, poor and rich.” The government has estimated 30 per cent of the population will be unable to afford their insurance payments and has weighted the system to ensure these shortfalls are covered by payments from wealthier citizens, says Emadeddin. The system will cover treatment of all kinds of illnesses and diseases, though ambulance and birth control services will be excluded. According to Emadeddin, it will also cover the cost of medical treatment abroad if such treatment is approved by the relevant specialised committee.
