Stages of implementation of universal health insurance
Stages of application of comprehensive health insurance Comprehensive social health insurance is a mandatory social solidarity health system in Egypt, working in accordance with Law No. 2 of 2018, which stipulates that comprehensive social health insurance is a mandatory system, based on social solidarity and its umbrella covers all citizens participating in the system, and the state bears its burdens for those who are unable based on a decision issued by the Prime Minister specifying the exemption controls, and the family is the main insurance coverage unit within the system, and this system is based on On the basis of separating funding from service provision, the Authority may not provide or participate in the provision of therapeutic services.
Learn about the new health insurance system Egypt health insurance
Comprehensive health insurance is based on separating the provision of service from its financing from the control mechanisms, and therefore 3 bodies assume the management of the comprehensive health insurance system, the Public Authority for Health Care and provides insurance health services, the Universal Health Insurance Authority and manages, finances and purchases health services, the General Authority for Health Accreditation and Control and undertakes the development of quality standards and accreditation of health facilities and health control on the sustainability of quality within health facilities.
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The implementation of the Universal Health Insurance Law is supervised by three bodies:
The Health Care Authority is concerned with service delivery outlets.
General Authority for Health Accreditation and Control: Hospitals are granted accreditation according to the quality standards in force.
General Authority for Universal Health Insurance: Manages and finances health insurance.
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Registration is done with the national number, opening the family file, conducting a comprehensive medical examination, following up with the family doctor for detection and diagnosis, obtaining medication and conducting tests, referral to a higher level of care if necessary, referring to the family doctor for follow-up.
Funding
The universal health insurance bill costs between 80 and 120 billion pounds and is implemented over 10 years in all governorates with funding from sources as diverse as Egyptian contributions, general government allocations, tobacco taxes and highway fees across the country. The Minister of Health indicated that the method of contribution is relative to the job of the contributor, and if he is unable the state will sponsor their participation, and the collection is done through the Universal Health Insurance Authority.
On October 14, 2021, President Abdel Fattah El-Sisi issued Resolution No. 190 of 2021 approving a loan agreement between the Government of the Republic of Egypt Arabic and the International Bank for Reconstruction and Development on the project to support the universal health insurance system in Egypt in the amount of $ 400 million, signed on January 20 and 21, 2021.
axles
The eight axes on which the comprehensive health insurance project is based:
Strategic planning.
Infrastructure and equipment preparation.
Automation and digital transformation.
Institutional transformation.
Qualification for registration and accreditation.
Human Resources and Training.
Registration and opening of family medicine files.
Awareness and information.
Services
The system's services include a range of health insurance services for all diseases provided to the insured within the Egypt, whether diagnostic, therapeutic, rehabilitation, medical or laboratory examinations such as:
The services of a family doctor or general practitioner in the specified treatment bodies.
Services of specialist physicians including those related to oral and dental medicine and surgery.
Home medical care where appropriate.
Treatment, hospitalization or specialized center, surgical procedures and other types of treatment.
Medical imaging examination, laboratory tests and other medical examinations and the like.
Rehabilitation services, physiotherapy and prosthetic devices in accordance with the basic lists issued by the specialized committees of the authority.
Editing prescriptions and dispensing medicines and supplies necessary for treatment in accordance with the basic and supplementary lists issued by the specialized committees of the authority, as well as making the necessary medical reports.
Primary and periodic medical examination for each candidate to verify his health and psychological fitness.
Treatment abroad for those who are impossible to treat through the services provided inside the Republic of Egypt Arabic and have treatment abroad, based on a report issued by a specialized committee in this regard and formed by the Authority, and the executive regulations clarify its procedures and controls.
Objectives
The strategic objectives of the Egyptian health system are based on 4 objectives:
Universal health coverage for all Egyptians.
Equitable distribution and equality among citizens.
Improving the quality of health services provided.
Government the health system to ensure efficiency and continuity.
Stages
The law applies in 6 phases, over a period of 15 years from 2018 to 2032:
The first phase in the governorates of: Port Said, Ismailia, Suez, South Sinai, Luxor, Aswan.
The second phase in the governorates of: Qena, Minya, Kafr El-Sheikh, Qalyubia and Matrouh.
The third phase in the governorates of: Alexandria, Beheira, Damietta and Sohag.
The fourth phase in the governorates of: Beni Suef, Assiut, Minya, New Valley, and Fayoum.
The fifth stage in the governorates of: Dakahlia, Sharqiya, Gharbia, and Menoufia.
The sixth and final phase in the governorates of: Cairo, Giza, and Qalyubia.
Timeline
In July 2019, President Abdel Fattah El-Sisi launched the signal for the effective start of the implementation of the universal health insurance system, from Port Said Governorate, marking the laying of the foundations of an integrated health system that includes one hundred million Egyptians in accordance with the latest international standards.
On February 16, 2021, President Abdel Fattah El-Sisi launched from the Ismailia Medical Complex in Ismailia Governorate, the signal to start the trial operation of the comprehensive health insurance system in 3 governorates in the first phase of the system, in order to start activating the new system in the governorates of Ismailia, Luxor and South Sinai.
On March 3, 2021, the Council of Ministers approved the draft decision of the President of the Republic on the concessional financing agreement between the Republic of Egypt Arabic and the International Bank for Reconstruction and Development on the project to support the universal health insurance system in Egypt in the amount of US$ 400 million.
On November 26, 2022, the Chairman of the Health Care Authority announced the start of operation of the new comprehensive health insurance system in Aswan Governorate, the fifth governorate to implement the new comprehensive health insurance system.
Affiliated Hospitals
Main article: List of hospitals of the Healthcare Authority in Egypt
Port
June 30 Hospital
Al , Hayat Port Fouad Hospital
Al , Salam Hospital Port Said
Al , Nasr Hospital
Al Tadamon Hospital
Ophthalmology Hospital in Port Said
Women's Health House Hospital
Ismailia
Ismailia Medical Complex
30 June International Center for Nephrology and Urology
Abu Khalifa Emergency Hospital
Fayed Specialized Hospital
Luxor
ISIS Maternity Specialty Hospital
Al Adesat Children's Hospital
Karnak International Hospital
Horus Specialized Hospital
Taiba Specialized Hospital
South Sinai
Sharm El Sheikh International Hospital
Ras Sidr Central Hospital
Taba Central Hospital
St. Catherine's Central Hospital
Aswan
Al Masala Specialized Hospital
Aswan General Hospital
Drew Central Hospital
Kom Ombo General Hospital
Horus General Hospital
Ophthalmology Specialized Hospital in Aswan
Suez
Suez Medical Complex
Sadr El Suez Hospital