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Financing health care in Egypt: Current issues and options for reform


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  • Gericke, Christian A.
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    Introduction: The Government of Egypt has embarked on a process of reforming health care financing in the country. Under the influence of external advisers it has so far focused on social health insurance as the main funding mechanism. Other options, in particular tax-based financing, have hardly been considered. Methods: Review of current health care financing arrangements in Egypt, of potential areas for improvement, and of stated health policy goals. Analysis of social health insurance and taxation-based financing on their ability to meet the stated policy goals and their viability. Results: Although both funding mechanisms have distinct advantages and disadvantages when applied to the Egyptian health system, tax-based financing seems better able to meet the official policy goals of the Government of Egypt than social health insurance on grounds of efficiency, equity and technical feasibility. Conclusions: The Government of Egypt will have to raise public health expenditure substantially to finance care at an adequate level. Expanding and refining the present tax-based financing scheme, rather than switching to an insurance-based scheme seems the technically superior strategy. Other measures to improve the coordination of financing, such as the creation of a single fundholding agency, are needed as well as tighter regulation of private providers and the pharmaceutical market. -- Hintergrund: Die ägyptische Regierung hat begonnen die Finanzierungs-mechanismen im Gesundheitssystem zu reformieren. Der Fokus der Überlegungen der Regierung und der externen Berater war bisher ein Sozialversicherungssystem. Andere Optionen, besonders ein aus Steuern finanziertes Gesundheitssystem, wurden bisher nicht ausreichend berücksichtigt. Methoden: Übersicht über derzeitige Finanzierungsmechanismen im ägyptischen Gesundheitssystem und Aufzeigen von möglichen Ansatzpunkten für Reformen und der gesundheitspolitischen Ziele der Regierung. Vergleichende Analyse des Verbesserungspotentials durch eine allgemeine Sozialversicherungspflicht oder eine Finanzierung aus Steuermitteln. Die offiziellen gesundheitspolitischen Ziele der Regierung werden dabei neben der technischen und politischen Umsetzbarkeit als Kriterien verwendet. Ergebnisse: Obwohl beide Finanzierungsmechanismen im Kontext des ägyptischen Gesundheitssystems unterschiedliche Vor- und Nachteile bieten, scheint eine Finanzierung aus Steuermitteln die geeignetere Finanzierungsart um die gesundheitspolitischen Ziele der Regierung wie Effizienz und Gerechtigkeit nachhaltig zu erreichen. Empfehlungen: Zum einen müsste die ägyptische Regierung die öffentliche Finanzierung des Gesundheitssystems deutlich erhöhen um eine adäquate Gesundheitsversorgung der Bevölkerung zu gewährleisten. Zum anderen scheint eine Ausweitung und Präzision des bestehenden steuerfinanzierten Systemanteils einer Ausweitung des Sozialversicherungsanteils die technisch überlegene Strategie zu sein. Andere flankierende Massnahmen wie die Schaffung einer zentralen Koordinationsstelle für die Gesundheitssystemfinanzierung und eine verbesserte Regulierung der privaten Anbieter und des Marktes für pharmazeutische Produkte sind ebenfalls wünschenswert.

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    Paper provided by Technische Universität Berlin, School of Economics and Management in its series Discussion Papers with number 2004/5.

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    Date of creation: 2004
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    Handle: RePEc:zbw:tubsem:20045

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