Changes to the health insurance system see the opposition raising the spectre of privatisation, reports Karim El-Khashab New health insurance regulations, which will come into effect by 2010, have caused alarm among the opposition and the Pharmacists' Syndicate. Both warn the new regulations could lead to the privatisation of the health care system. Minister of Health Hatem El-Gabaly explains that under the new regulations citizens will have to pay up to 25 per cent of the cost of medical treatment and up to 30 per cent of the cost of prescriptions. "The aim is two-fold," El-Gabaly explained. "One is to improve the standard of service provided to the public, which is why we are creating a separate, government entity to oversee the administration of health insurance. The second is to ensure government funds reach the people who really need support while letting those who can pay for services to do so." The poorest, El-Gabaly added, would be exempted from charges, and hospitals would continue to treat those in a critical condition regardless. The scheme will first be tested in the governorates of Sohag, Damietta and Suez. MP Farid Ismail, a member of the People's Assembly Health Committee charged with drafting the new law, says the three governorates were chosen because of their higher than average income levels. "It is important to take into account," he says, "that under the new plans all Egyptians will be obliged to be covered whereas now only 52 per cent have health insurance". Ismail adds that the committee is also considering further exemptions, including those with chronic illnesses. Head of the Pharmacists' Syndicate Gamal Abdel-Wahab told Al-Ahram Weekly syndicate members were strenuously opposed to the changes. The new law, he argues, places tremendous power in the new insurance entity's hands which will allow it to favour certain drug manufacturers over others and drive up the price of drugs. The law, he said, "marginalises a large percentage of the population, especially the unemployed, and could easily lead to a two-tier system of insurance, one for those who can pay and another for those who can't". In addition, the new insurance entity will have the right to invite other companies to help it administer and provide services. "This not only opens the door for privatisation of the health sector but also for groups such as the Muslim Brotherhood to have greater influence in the health sector." The Muslim Brotherhood has opened dozens of clinics, particularly in rural areas, in an attempt to gain popularity. This spectre of privatisation worries many despite official assurances the government has no plans in this regard. Independent MP Mohamed Monatasser told the Weekly that the pattern is already familiar. "First they said they would not privatise certain banks and then they did. Now they are saying the same thing about health care." The new body being set up to administer the system is, says Montasser, simply a cover. It will invite the private sector to oversee some parts of the process, claiming it is more efficient that way and then, before anyone realises it, the whole system is privatised. "The aim is to provide broader and better health care for the public. By having these fees and splitting the service and management aspects we can achieve this, it is that simple," says El-Gabaly. "People want real service, one that can meet their needs, and this is what we are providing here, for the first time in quite a while," he said, adding that the government knows very well that there are people who cannot afford the new fees and who must be exempted. "I see no need to scare the people."
