Egypt: Universal Health Insurance Offers Opportunities For Health Insurers

In this iPMI Global country guide article, author of the brand new 2024 report, The Future of International Private Medical Insurance (iPMI), Ian Youngman, looks at news out of Egypt, about universal health insurance.

• Healthcare has been a priority for Egyptian governments since 1936, but coverage is far from universal.
• The country established its Health Insurance Organisation (HIO) in 1964 but at present this covers only 60% of the population, offering basic healthcare to students, workers (in government, and in formal public and private sectors) and pensioners. 
• The Egyptian parliament passed a universal health insurance (UHI) law in 2018, promising to provide comprehensive healthcare coverage for all residents of Egypt.
• It established the Universal Health Insurance Authority as an independent agency to merge all insurance pools (public and private) into a single pool and introduce new roles for private health insurance. 
• UHI is funded by contributions from employees of the government and of the public and private sectors, with tax top-ups to cover groups that do not contribute, such as students, pensioners, the unemployed and informal sector workers. 
• But UHI service packages are likely to be insufficient, thanks to factors including high unemployment, large numbers of informal sector workers, and a significant proportion of the population being under the age of 15.
• This means people could still end up paying out of pocket. Private insurers can step up to address unmet healthcare funding needs and ensure UHI’s sustainability. 
• Private insurers need to develop strategies to satisfy changing consumer demand as UHI is implemented in wider geographies.
• Private insurers act as risk pooling schemes and could reduce the burden on UHI – but, left unregulated, an undesirable healthcare market may develop, driving inequality.
• The UHI Bylaw prescribes complementary and supplementary roles for PHI, stating: “All natural, legal persons or administrative bodies may enter into contracts with private insurance companies located within the Republic to take advantage of them to pay the difference in the prices of the cost-sharing borne by the patient or the difference in the cost of the insurance class for a stay in hospital or receipt of other supplementary services.”
• These regulations permit individuals and legal bodies to seek PMI to cover costs associated with using UHI services, such as co-payment charges, costs of additional services not covered by UHI, and complementary services.
• The role can be divided into two categories:
• Supplementary health insurance, functioning as a guarantee to faster access to healthcare services and providing more choice for the insured
• Complementary health insurance- complementing the public service provided by the UHI, or providing an alternative option to this service such as at private providers).

Analysis

• The logic would seem to have two products- supplementary PMI and complementary PMI.
• But that is very messy.
• A simpler solution would be to combine them with in country and overseas treatment in IPMI for locals and expats.  

Related Reading: International Health Insurance 2024: The Future of International Private Medical Insurance (iPMI)

About the Author

Ian Youngman is an independent writer and researcher specialising in insurance. He writes regularly for a variety of magazines, newsletters, and on-line services. He publishes a range of market reports, and undertakes research for companies. To read his latest report, International Health Insurance 2024: The Future of International Private Medical Insurance (iPMI), please click here, or visit the REPORTS section of iPMI Global.