Commercial health insurers are confident that the government's comprehensive health insurance scheme will have little impact on their business, and are eager to play a part to contribute to the scheme.
The reasons for the confidence stem from the proposed gradual implementation of the government-run health insurance scheme over the next 15 years, as well as the quality of services provided by the private sector compared to that in the public sector, reported Al Mal.
Mr Mohamed Mokhtar, head of the medical treatment department at Misr Insurance, says that the impact of the comprehensive government health insurance law on private medical insurance activity is limited because the scheme is to be introduced nationwide over at least 15 years. The scheme is to be rolled out in the middle of this year until it covers the whole country by 2032.
He expects that there will be difficulties in applying the law, and that several questions need to be ironed out. He asks whether the scheme would apply to workers or to residents in a governorate. For example, if there is a worker from Upper Egypt who works in the Suez Governorate and is entitled to the medical insurance card in the Assiut governorate, would the worker be covered by the comprehensive health insurance system in Suez? Will his family be supported in Assiut? If he returns to his province of Assiut, and is sick, is he covered by the health insurance scheme?
He points out that the comprehensive government health insurance system needs a sophisticated IT system to link service management with the service provider network to control approvals, claims, and usage. The IT system is yet to be available.
Dr Sherif Sabry, director of the Medical Claims Department at Royal Insurance Egypt, says that insurance companies have several reservations about the new health law, particularly the articles related to the participation of other parties. He said that executive regulations related to the comprehensive health insurance scheme have yet to be issued. There is currently a lack of agreement on prices as well as lack of clarity of programmes.
Mr Alaa El-Zoheiry, Chairman of the Insurance Federation of Egypt, said that the association is liaising with the Egyptian Financial Supervisory Authority to seek a role for insurance companies in the new health insurance scheme. He stressed the successful experience of insurance companies in providing healthcare coverage and their commitment to pay compensation to policyholders, citing these as reasons why insures can play an important role in the universal health insurance scheme.