Universal Health

Insurance
By

Amany Ayman Mokhtar

 Approaches
The Problem

Importance of Universal Health

Insurance

Implementation of Universal
Health Insurance
 The Problem

 Discussion about:
• The Approval about the new Universal Health Insurance
Law
• Amount of the income which is spent about the family
health.
• The coverage of the Universal Health Insurance.
• Accessibility of the Healthcare services.
• Benefit Packages are provided by Universal Health
Insurance
 Importance of Universal
Health Insurance
 All people have access to the health services they need,
when and where they need them, without financial
hardship.

 The reduction of out of pocket expenditures.

 Promotion of equity, efficiency and effectiveness.

 How can we apply the
Universal Health Insurance

 Who is covered?

 What services are covered (and at what level of

quality)?

 How much financial protection do citizens have

when accessing services?
High-Level action points
Short term, Medium term &Long term
 Establishment of national high level multi stakeholder
commission.

 Setting up of an implementation working group on

strategic purchasing.

 Development of a joint & integrated implementation

plan for all ministries & organizations involved in
purchasing including a monitoring & evaluation plan.
High-Level action points
Short term, Medium term &Long term

 Communication & Engagement with all stakeholders

and above all the public on the law and its
implications related to purchasing.

 launching a comprehensive organizational

development of the UHI organization with clear
organizational structures, duties and responsibilities.
Specific action points
 Benefit Package Design
 Establishment of benefit package committee.

 Defining the process & the criteria of specifying benefits &

the ways of citizens involvement.

 Referral system

 From lower level to higher level

 Primary care Level to Specialized level

Specific action points
 Cost-sharing
 Reduction of copayments for generic ( therapeutic
medication to induce more efficient use of resources.
 Set lower Copayments for specific population groups.
 Adjusting the cost ceilings with income level .
 Health Information management system
 Design & implement of HMIS ” Health Management Information System.”

 Establishment a steering Committee to coordinate across all

miniseries.
Specific action points
 Payment Methods
 Governance Committee
 Supervision on public health functions

 Coordination between the “old” & “ new “ system during

the implementation phase

 Supervision of quality

 Set up a health services delivery map

 Assess implication of the implementation plan

 Strength participation & accountability mechanisms

 References

1.Arguing for Universal Health Coverage. WHO

2. Universal Health Insurance Law In Egypt

3. Implementation of Universal Health Insurance Law In Egypt, WHO