The Ministry of Health largest provider of health services

11. spread throughout Egypt similarly about 5000 plant primary care and 1,200 plant secondary care, and belongs Both types of the private sector, where he looks at these private facilities as quality services higher; and chooses people who are unable to pay public service providers from the private sector spending, especially welfare outpatient.
12. The Ministry of Health largest provider of health services (free and subsidized), which is financed from taxes on income and other types of taxes and fees allocated to it. The facilities include the ministry about 4 thousands of primary care facility and 1,100 secondary care facility, and all citizens can benefit from them “for free”. However, it must be on the citizens to pay their own money in exchange for access to health care is contained within the specified categories of therapeutic services. This includes analysis laboratories and laboratory fees and the price of medicine. As is the case for service providers under contract with the General Authority for Health Insurance, the quality of services provided by the service providers Affiliates of the Ministry of Health, which is also of poor quality in general.
13. Ministry of Health and have two separate programs from the payment of service costs two programs: the treatment program at the expense of the state, and the program of the new Family Health Fund. Treatment program at the expense of the state and aims to protect Egyptians from the impact of diseases that require expensive treatment, in particular on the financial situation. But this program is currently on a cold expenses paid for routine care, since there are no clear standards for coverage and funding. A study funded by the Ministry of Health in late 2006 that less than 30 per cent of the funding is used in the actual personal health disaster coverage. Instead, it is often used this program to get the health care facilities of the highest quality for people who can do so through political influence or through other means. In 2005, the expenses of the program exceeded its budget by 100 per cent, and the accumulation of the deficit-to-date in the amount of US $ 500 million. And over so that the treatment program at the expense of the state spends an increase of 40 per cent per annum of expenditures by the General Authority for Health Insurance Although there are only about 1.7 million people compared with 38 million people covered by the Commission covers.
14. Family Health Fund is newly established to pay the costs side. This fund has been established within the framework of Health Sector Reform Project (Health Sector Reform Project, No. 3076) with funding from the World Bank, which is an integral part of the “model family health” port in the framework of this project. The Family Health Fund has been piloted in five provinces (out of 27 governorates), as established in order to finance the newly established family health model, the Fund contracts with primary care institutions restructured to provide family health model, etc. services. Fund does not hire only certified facilities of the model of family health. And succeeded this model since 2005 to improve the quality of service providers through new forms of pay-for-performance, compact and reliable method of use. And to monitor the levels of use of services and tuned (utilization control), demanding the model facilities charges a nominal registration fee and co-payment (except that the members of the General Authority for Health Insurance are currently exempt from this fee). This model is applied in nearly 800 belonging to the Ministry of Health primary care facility, the Egyptian government adopted in 2005 a formal organizational model for the health of the family in all parts of the country.
15. The absence of justice and equality among citizens, despite the significant role played by the public sector in the provision of health services and funding. Total spending increases on health care from public and private sources in urban provinces increased by 2.5 times for total spending in rural Upper Egypt governorates. There is also a preference for urban governorates of the richest in the distribution of health facilities to the public sector (such as, for example: hospital beds). Thursday and spent the richest of the population 2.3 times on hospital care and 1.6 times on the services provided by the outpatient larger than it spends ratio of 20 per cent of the poorest households.
16. Egypt has undertaken efforts aimed at reforming the health care system for more than a decade. In 1997 the authorities in charge in Egypt, developed a plan to reform the health sector in the country (with support from the World Bank, the European Union, the United States Agency for International Development, the Danish Agency for International Development). Although it was not all initiatives included in the plan is realized, the health insurance coverage has been extended to include children under school age, pupils and students. Massive expansion, as happened in the main scope of personal health disaster program on Persons uninsured.
17. The process of reform in 2005 has received a major momentum when President Mubarak announced a new framework for the medium term to reform the health sector. And calls for this framework to (a) improve the administrative capacity and financial sustainability of the General Authority for Health Insurance, (b) expand primary health care coverage for the fund family health to all the provinces, and (c) improve the performance of all state-owned hospitals, and (d) expanding access health services to cover all Egyptian citizens uninsured through the application of a mandatory program of social health insurance, (e) the integration of all of these ingredients in the social health insurance and a national system in the medium term.
18. One of the critical steps in the reform process in the adoption of a new law of social health insurance. This law envisages the establishment of a new party shall pay the costs of therapeutic services arrangements, which in turn will be absorbed by the beneficiaries of the General Authority for Health Insurance, and administrative resources. The World Bank has provided technical assistance to the authorities responsible with regard to funding standards, legislative and dimensions, and the reforms involved in the provision of services. It has also been an actuarial model to estimate the costs of preparing the reform process. The aim of the social health insurance system reforms to be blessed with all citizens universal health care. This would be achieved by broadening the scope of participation in shouldering the burdens and risks, and improve service quality and efficiency, and to prevent the fragmentation of financing arrangements and the provision of services.
19. believes that the new legislation will be to participate in the compulsory social health insurance system, the State bears the payment of contributions for the poor, who are unable through direct support. It will enable subscriptions beneficiaries allocated in the general budget and resources to support the poor, who can not – the authority responsible for paying the costs of the services of burden-sharing and risk widely across income groups, age groups, and other at-risk groups. Expects the responsible authorities at present to represent the budgetary resources (dedicated to the payment of contributions for the poor, who can not support) is about 20 per cent of the funding for the system of social health insurance, while it may need to be reconsidered in this ratio based on the latest data for the analysis of the levels of use health care and poverty data. The breadth of participation to deepen the financing of health care in the social solidarity. As for household individual, the risk of draining their financial resources as a result of their exposure to health disasters figure will diminish too, it is about what repaying the joint payments and incur a small deductions that reduce their vulnerability to financial crises (subject to production of a membership card in the social health insurance system and the card personal identification ).
20. targeted consultative process for the government parties and the main groups concerned. Still the Egyptian government – represented by the Ministry of Health – conducting consultations had been initiated in the past two years with a variety of stakeholders on the new social health insurance system of law. These consultations have included many of the unions, the Commission for Health Affairs in parliament, and unions, and leaders of the National Democratic Party, and discussions in the media, which published a number of drafts of the new law, ect. Due to these reforms prejudice the lives of all the inhabitants of Egypt with their families and include several technical dimensions can be interpreted wrong, it was a long debate around much of the difficulties and challenges and characterized. The World Bank and reviewed some of the documents related to these consultations, and concluded that the Ministry of Health has made a great effort to communicate with many parties and constituencies and listen to their concerns. It is expected the World Bank – in any case – that the ongoing public debate continues on the nature of the challenges at a time when Parliament discusses the new law before the release, and to continue as well as during the implementation period. It is also expected that the government’s strategy to ensure a strong informational and consultative process of the reform program in the framework of this program.
21. The implementation of a single national body to pay the costs of the service in Egypt, a long-term and gradual stages effort arrangements. Responsible authorities and aim to share 85 per cent of Egyptians in the National Authority for health insurance by the year 2028. Once the entry into force of the new legislation begins in its final form appropriate, begin the first phase and that a pilot project in Suez Governorate, which in turn will create a new national body that holds the payment arrangements in the context of social health insurance system, and at the same time it enhances the capabilities and arrangements for health care providers in the province. The predominantly Suez urban character, with a population of about 500 thousand people, and a large informal sector of the economy, with the informal sector is concentrated in the fishing and represent its workers associations of fishermen. The form at present a pilot project team of staff (who were selected from among the General Authority for Health Insurance) staff, this team and put under the authority of the governor of Suez to ensure close coordination between the innovative measures adopted by the point of payment and service providers. As it has been the establishment of an administrative infrastructure (of resources

The performance of the overall economy

1. Egypt’s population is estimated at about 83 million inhabitants (2009), and a third of that number under the age of 16 years. The estimated population increase in Egypt increased by 1.75 per cent a year, which was due in part to the fertility of 2.9 births per woman rate. The average life expectancy at birth stands at 74 years for women and 69 years for males (2007), which is a good average compared to the averages prevailing in other countries with the same level of development. Egypt is going through at the same time shifts epidemiological witnessing the increasing number of non-communicable diseases and injuries that are likely to require a steady increase in the cost of health care.
2. The performance of the overall economy is relatively strong in recent years, and in spite of the damage caused by the global economic crisis. Egypt and classed as lower-middle income countries have gross national income was 119.45 billion US dollars, has a per capita amounted to gross national income of US $ 1580 in 2007 (per capita gross national income in terms of purchasing power parity of US $ 5370) . In the past three years, the Egyptian economy witnessed a growth in the range of 7 per cent a year, but is expected to slow to between 4.5 per cent and 4.7 per cent for this year and next year as a result of emerging from the global economic slowdown, the impact (and the concomitant decline in rates inflation in the range of 8-12 per cent per annum of the international Monetary Fund, 2009). And it witnessed the same period, the implementation of significant reforms, including: reform of tax systems, and financial sector reforms, privatization and the application of large-scale program.
3. The budget deficit remains high despite the steady decline in recent years. It was to reduce the deficit in the overall budget (Pan government) of 9.2 per cent of GDP in fiscal 2006 to an estimated 6.9 per cent in fiscal year 2009. But the Ministry of Finance estimates that the resumption of the height of the deficit in fiscal 2010 to 8.4 percent of GDP, which is partly due to the slowdown of the main sources of income and higher interest rates expenses that result mostly from domestic borrowing. The most advice given by the World Bank, the Egyptian government on the need to continue to focus on the management of public expenditure items in the medium-term planning, and it despite the fact that the existing fiscal stance on the expansion of expenditure items was justified during the crisis to continue the original path of the policy of fiscal adjustment in order to support the growth of private investment and increase productivity.
4. The economic and social reform efforts despite the ongoing uncertainty that harbors the general public due to the lack of sharing the fruits of success on a large scale. This suspicion seems clear to leaders who speak frankly about this point, and can lead to improve the delivery of public services – including health care services – to broaden popular support other difficult reforms. Apart from that, the better standards of efficiency and equity in the provision of social services is crucial to continue the successes achieved in the Egyptian economy. In the past four years, the government has developed the concept of social health insurance as one to address these challenges tools. In addition, the government has the following steps: (1) expand the monetary assistance program to 800 thousand families, with plans for further increases; (2) the implementation of pilot programs to improve the process of identifying the poor and improve the targeting of social benefits; (3) improve to provide housing services , transportation, water, and sanitation; (4) integrated rural development for a thousand of the poorest villages. These steps represent together an ambitious reform program components complement each other. For example, it is of effective targeting of the poor and other marginalized groups and is capable of in the social health insurance system reformed of paramount importance to ensure fiscal sustainability.
5. increased spending on health care at rates faster than the rate of economic growth over the past decade. The total spending of 3.9 per cent rose from GDP in 1995 to 6.1 per cent in 2006, which is equivalent to about 45 billion Egyptian pounds (US $ 8.3 billion) and 40 per cent faster than the growth of GDP (IMF, 2009 report, which dealt with the implications of the reform of pension systems and health care to the state treasury). Moreover, it has increased public health spending – which accounts for about 3.6 percent of total health care spending as a share of GDP – almost faster increase of 30 per cent of the economic growth rate during this period. Also it saw direct incidental expenses paid by the citizens (Out-of-pocket) increased significantly, rising from 1.8 per cent to 3.6 per cent of GDP, equivalent to about 60 per cent of the total spending on health care. If spending continues on health care surpassed income growth at the current rate, it is expected it to be approximately 13 per cent of GDP by 2025.
6. forms contain costs while addressing to address issues related to distribution and efficiency in one of the central themes in the reform process of financing the health sector of the health system. In addition to the need to find more effective ways to control public spending on services, it faces several challenges related to the quality of services provided by the Egyptian health sector, and the availability of care services, and levels of use, and efficient utilization of resources. For example, the average bed occupancy rates in hospitals only 40 per cent at the national level, which indicates a decline in the terrible customization, it also significantly lower than in many of the countries that Egypt may want them in the same comparison.
7. Located about 50 per cent of Egyptians outside the umbrella of health insurance services. Belong to the majority of uninsured individuals into the informal sector and the poor, who are unable, as well as persons who have dependents insured by labor, as well as workers in small and medium-sized institutions of the formal sector. And adopt these populations are highly dependent on the free care provided by the Ministry of Health, so that they can get the health services. In spite of the availability of free health care, the direct-pocket expenses paid by citizens representing an estimated 62 per cent of spending on health care services for uninsured persons. And it spends about 60 per cent of that on the services provided by hospitals and outpatient clinics, and covers spending on medicines and other lotions rest. As a result, personal health disaster is a source of great danger to drain the financial resources of many Egyptian families and individuals.
8. General Authority for health insurance covers most of the other residents, including: working in the civil service, labor and the private sector covered by the formal economy, and children under school age, schoolchildren and pensioners, widows. The interview comes premiums to the body of the taxes levied on salaries through the collection arm of the National Authority for Social Insurance, or through taxes and public fees and revenues allocated for this purpose.
9. General Authority for Health Insurance hand integrated shall pay the cost and delivery of health services arrangements, which offer subscribers a comprehensive package of health care services through a network consist of nearly 9 thousand Facility for primary care (mostly small clinics in schools) and approximately 40 attached to secondary care (hospitals ). The results of a recent survey targeted households that the quality of health services provided by the Authority does not live up to the required level and that the beneficiaries of subscribers by avoiding the habit affiliates and service providers are paying personal pocket for health services outside private clinics. In general, do not represent the guided tours to get the health services of the General Authority for Health Insurance or service providers of its facilities only 5-10 per cent of all visits by the population for this purpose, and in spite of that the body covers half of the population. The reasons for the low quality of the body are numerous and diverse services, but there is one reason pivotal, namely the integrated model to the buyer of the service point of submission and the nature of the character of the body. The limits of this arrangement, among other things, the incentives associated with efficient resource management and competition to improve the quality of services by health care providers.
10. private health insurance market is experiencing rapid growth, in Cairo alone, covering forty-eight health care plan prepayments two million beneficiaries. And created 70 per cent of the coverage of the private sector through employers groups (including, notably, the Ministry of Finance as well as other government agencies). And it demonstrates paid growth plans in advance of the growing “Pick out” of employers under the umbrella of the General Authority for Health Insurance. But most of these plans put a cap to cover the 10 thousand Egyptian pounds ($ 2,000) approx.