Health Care Reform: Egyptian Edition

A financial dispute between several Egyptian hospitals and the Ministry of Health is leaving thousands of Egyptians without access to health care and vital medication, as hospitals refuse to treat patients across the country.

Even prior to this crisis, the health care situation was bad enough: Only 53% of Egyptians have health insurance. The rest of the population is eligible for -- and until recently, some received -- free health care funded by the Egyptian government. But still, only about two million people (out of a population of more than 81 million) take advantage of the free government health care option.

Recently, several hospitals have begun demanding overdue payments from the Ministry of Health, declaring that they won't honor free government health care agreements until these bills are paid. That sounds reasonable, but in the meantime, it's the people who depend on free health care to survive who are bearing the brunt of their decision. While hospitals wait to be paid, thousands of requests for care and prescriptions are being delayed or left unfilled.

Some sources say the Ministry of Health owes an outstanding one billion Egyptian pounds ($270 million) to health care facilities around the country. If that weren't enough, in early January, allegations of rampant corruption and fraud within the free health care program surfaced, causing some hospitals are refusing to treat patients until the government investigates the charges.

And it gets uglier.

Several members of the Egyptian parliament have been accused of authorizing constituents for the free health care program -- constituents who could afford to pay for health insurance -- while reaping a tidy profit in return. The case of Egypt's finance minister in particular, who allegedly received the equivalent of millions of Egyptian pounds in free care, has evoked outrage from the program's mostly low-income participants. Now, accusations are flying on all sides, and some medical facilities are likewise being accused of overcharging for their services.

At least no one is calling health care reform unconstitutional: Egypt's National Charter, drafted in 1962, states that "the right of health welfare is foremost among the rights of every citizen." In the last World Health Organization survey, Egypt's health care system was ranked 63rd.

Yet activists and government officials alike agree it is due for an overhaul. Health care activists hope that current differences can be resolved through a new health care bill. Under the projected legislation, all Egyptians would pay a monthly premium in return for care, with the exception of around 20% of the population who would be eligible for government-subsidized premiums. And yet so far, the bill's drafting has been delayed,because the Ministry of Health says it must have a source of sustainable funding before it can proceed.  Sound familiar?

In the meantime, many of Egypt's most vulnerable have no recourse but to watch and wait while activists and civil society groups alternately pressure the government and the health care system, asking each to please stop punishing the poor for what comes down to high-level corruption and mismanagement.

Photo Credit: gr33ndata