slide1 n.
Download
Skip this Video
Download Presentation
Health Insurance Organization in Egypt by Dr Abdel Rahman El- Sakka

Loading in 2 Seconds...

play fullscreen
1 / 31

Health Insurance Organization in Egypt by Dr Abdel Rahman El- Sakka - PowerPoint PPT Presentation


  • 111 Views
  • Uploaded on

Health Insurance Organization in Egypt by Dr Abdel Rahman El- Sakka Health Insurance Organization, Chaiman 8 October 2012. Health Insurance Organization in Egypt. The pic of HIO. Health Insurance Organization (HIO).

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'Health Insurance Organization in Egypt by Dr Abdel Rahman El- Sakka' - munin


Download Now An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
slide1

Health Insurance Organizationin Egypt

by

Dr Abdel Rahman El-Sakka

Health Insurance Organization, Chaiman

8 October 2012

health insurance organization hio
Health Insurance Organization (HIO)
  • The social health insurance system (HIO) in Egypt has been in existence since 1964
  • HIO was the outcome of many legislations started in the early decades of the 20th century
hio current laws
HIO Current Laws
  • Law 79/1975
  • Law 32/1975
  • Prime Minister Decree 1/1981
  • Law 99/1992
  • Law 86/2012 (Minister of Health Decree 380/1997)
hio current laws cont
HIO Current Laws (cont.)

Law 79/1975

  • Covers; Government, Public & Private employees
  • Premium: 4% of Total Salary (1% from beneficiary & 3% from employer)
hio current laws cont1
HIO Current Laws (cont.)

Law 79/1975

  • Covers Pensioners
  • Premium: 1% of Salary
hio current laws cont2
HIO Current Laws (cont.)

Law 32/1975

  • Covers; Government & Local Administrative Units Employees.
  • Premium: 2% of Basic Salary (0.5 % from beneficiary & 1.5 % from employer , in addition to some cost sharing)
hio current laws cont3
HIO Current Laws (cont.)

Prime Minister Decree 1/1981

  • Covers widows (of HIO beneficiaries)
  • Premium: 2% of Salary
hio current laws cont4
HIO Current Laws (cont.)

Law 99/1992

  • Covers school students
  • Financing:
  • 4 EGP annual premium paid by student
  • 12 EGP annual contribution for each student by Ministry of Finance
  • Co-insurance: One-third of outpatient medications (except chronic diseases)
  • Earmarked Tax: 10 piasters per pack of cigarette
hio current laws cont5
HIO Current Laws (cont.)

Minister of Health Decree 380/1997

  • Covers neonates & preschool children (Voluntary!!)
  • Financing:
  • 20 EGP annual Premium
  • Co-insurance: One-third of outpatient medications (except chronic diseases)
hio current laws cont6
HIO Current Laws (cont.)

Law 86/2012

  • Covers neonates & preschool age children
  • Awaiting the executive decree
  • Financing:
  • 8 EGP annual premium paid by child parent
  • 12 EGP annual contribution for each student by Ministry of Finance
  • Awaiting the executive ministerial decree
hio current laws cont7
HIO Current Laws (cont.)

Labor Injuries Insurance (Law 79/1975)

  • Covers all labor force covered by the law 79/1975 & others!!
  • Premium: 1% of salary (paid by employer)
hio provides services to beneficiaries all over egypt from alexandria to aswan
HIO provides services to beneficiaries all over Egypt from Alexandria to Aswan

HIO Owns:

  • 22 regional administrative branches
  • 38 hospitals
  • 354 polyclinics
  • 829 (GP) clinics inside factories,
  • 78 Labor injuries centers
  • 34 general medical committees
  • > 8000 school clinics 
  • Outsourcing (contracted):(640 hospitals – 3286 out-patient rural clinics)
scope of services
Scope of services
  • Preventive
  • Diagnostic
  • Therapeutic
  • Rehabilitation
high cost services provided in the year 2011 2012
High cost Services Provided in the Year 2011/ 2012

Cardiac Services

Diagnostic Cardiac Cath:13,112

Therapeutic Cardiac Cath:7,176

Open Heart Surgery: 5,470

high cost services provided in the year 2011 20121
High cost Services Provided in the Year 2011/ 2012
  • 372 Corneal transplantation
  • 258 Bone marrow transplantation
  • 358 Cochlear implantation
  • 92 Liver transplantation
  • 1300 cases of GH deficiency in children
high cost services provided in the year 2011 20122
High cost Services Provided in the Year 2011/ 2012

Long Acting Interferon Therapy

For more than 24,000

hepatitis C patient

services provided in the year 2011 2012
Services Provided in the Year 2011/2012
  • HIO provided school children diabetic patients with around 16.700 Insulin pen
services provided in the year 2011 20121
Services Provided in the Year 2011/2012

Gamma Knife Treatment

For 300 cases

of Brain Tumor

services provided in the year 2011 20122
Services Provided in the Year 2011/2012

Renal Dialysis

  • 13,000 patients
  • 33 owned dialysis centers
  • (632 Haemodialysis device)
  • 455 contracted centers
services provided in the year 2011 20123
Services Provided in the Year 2011/2012

Chemotherapy

197,000 visits for chemotherapy sessions

main challenges facing the current hio
Main Challenges Facing the Current HIO
  • Incomplete coverage
  • Different Laws & Systems
  • Unrealistic rates of premium
main challenges facing the current hio1
Main Challenges Facing the Current HIO
  • Continuous advances in Healthcare Industry
  • Technology & Knowledge revolution; a paradigm shift
  • Unclear (implicit) Benefit Package
  • Opt out strategy (Low health risk group)
slide29

Main Challenges Facing the Current HIO

  • Voluntary enrolment of some groups
  • Extension of Occupational diseases list (financial burden)
  • HIO is the payer and service provider
health insurance reform in egypt
Health insurance reform in Egypt

Aiming at:

  • Universal coverage
  • Sustainable financing resources
  • High level quality health care
  • Unifying the laws
  • Payer/provider split