To contribute to the financial sustainability of the system of social health insurance
193. is unlikely to represent the financial sustainability of the activities of implementation will begin within the Health Insurance Systems Development Project a problem, given the potential for return on investment, as explained above, and close monitoring of the project be undertaken by the company specialized in the verification and validation, which will be contracted to the project.
194. offers Health Insurance Systems Development Support Project is very important for the financial sustainability of the program of social health insurance as a whole, which requires the implementation of a number of measures (a) appropriate subscription rates; (b) comply with contributions (c) The level of commitment by the state to provide the necessary subsidies and any additional transfers from the budget to prevent the accumulation of debt down to bankruptcy at the end (d) clarity about shared responsibilities between the state and complex assessments in connection with the financing of health benefits (e) the new health insurance management’s ability to money management to effectively contain costs with quality assurance. And it will support the technical skills, technologies and systems that will include the development of health insurance systems significantly these measures and then the project will help to achieve sustainability for the entire system.
195. One of the critical aspects important to ensure financial sustainability of the program of social health insurance, where the financial capacity and the budget available is limited to the government, to ensure the priority given to cover goods and services that have the greatest health impact and to protect the populations which prove their inability to afford the cost in Especially. And it will enable the technical skills, technologies and systems that will include the development of health insurance systems, a project of the National Authority for health insurance from the implementation of a more structured review of the basic system of social health insurance for the elements of a package of benefits, medical fees, and rates of subscription.
Fourth: The internal rate of return of the project investments
Nord 196. The following is a summary of the revenue generated in the project; based on the assumptions described above and to set the financial costs of the investment project.
Benefits / costs of the current value of inflows (US $)
Savings due to the anti-manipulation and fraud, and to prevent the misuse of resources, and administrative efficiency gains (see above for details)
Net cash flow after deducting recurring costs: $ 111 million until 2020 (discount rate 10 per cent)
Investment costs as well as recurring costs. It expected to stabilize recurrent costs at the end of the investment period and to grow at a steady rate thereafter – hard depreciation of equipment / machines
Investment: $ 75 million (the discount rate to 10 per cent)
Net present value
Internal rate of return US $ 36 million
48 per cent
197. stop the sensitivity of the revenue estimates on the extent of incompetence and scope of the improvements in the three provinces where the project is implemented. There is no evidence of this, and then there is nothing to indicate that the context is favorable or unfavorable, particularly in these provinces compared to other parts of the country.
198. Assuming that these three pilot provinces together make up one-third of health care spending would total health expenditures to approximate these provinces 2.73 billion US states (the total spending on health care in 2007 in Egypt, 8.2 billion US dollars). It produces a draw dividing the cost of the project amounting to US $ 75 million for health expenses of the experimental points to the provinces, giving almost 2.7 per cent. And swinging the occurrence improve overall efficiency through project investments was 2.7 per cent up on the short-term, which will cover the period of the immediate implementation of the project.
Technical extension of the facility 9: return of investment rate and the net present value
199. The following analysis calculates the net present value of investments based on the assumptions stated above concerning the benefits and estimated revenues associated. Moreover, exchange rate calculations assume a uniform during the implementation period, with revenues likely to be realized after the first year. The assumption of three alternative scenarios based on the speed of outgoing payments and proceeds.
Note: Assuming a discount rate of 10 per cent with a unified exchange rate
200. As is shown in the table above, the net present value is positive after the second year in both scenarios. It is estimated that the rate of financial return of the project will be in the range of 48 per cent in the baseline scenario over the next ten years. This will result in a failure to implement the project – according to the schedule and take full advantage of the benefits – less return; on the contrary, the rapid and effective implementation could lead to a return of more than 100 per cent.
201. The following figure shows the current values of the revenues for each scenario.