It ensures that individuals have access to necessary medical treatments and services in top clinics and hospitals, comprehensive medical examinations, hospital stays, surgical procedures, and cancer treatments. Additionally, it covers the costs of medications and chronic disease treatments. This insurance provides peace of mind, knowing that you can receive proper treatment at all times and alleviates concerns about sudden illnesses or the need for surgical procedures, as the insurance covers the associated costs.
Knowing the advantages and disadvantages of universal health insurance, we should know that universal health insurance is a social system through which the state provides medical services to all segments of society without discrimination, and the state bears the burdens of the material cost for the unable in order to reduce disease rates and provide medical protection for all citizens.
Comprehensive insurance is an insurance system that aims to reduce poverty and disease rates, by reducing or transferring the financial burden that occurs in the event of illness from the citizen and full bearing to a strong integrated financial system that can control and control these burdens.
Comprehensive insurance also provides integrated medical protection for all family members in exchange for monthly reduced amounts for those who are able only, but in the case of those who are unable to do so, the state bears the material cost of covering the health burdens on behalf of those who are unable to do so.
In the end, if we follow this approach, the state will help citizens to ration large financial spending on the health aspect of the individual and family, and promote a better standard of living.
What is the difference between current health insurance and comprehensive health insurance?
The current health insurance covers 50% of the community and the insured individual is responsible for obtaining a policy that suits them.
Comprehensive health insurance, on the other hand, aims to cover all members of the community, including entire families, rather than just individuals.
To benefit from the comprehensive health insurance system, it is not required to undergo large details, only the subscriber needs to:
He is obligated to pay the specified amount of health insurance and pay the contributions required of him on time.
To be of the two non-estimated "with proof of that case", so the public treasury bears the burden of paying the subscription
In the event that the citizen does not participate or is late in paying the contribution required to benefit from the comprehensive health insurance services, he only needs to pay the late contributions in one payment or in installments, except in emergency cases.
The responsible entities for activating the comprehensive health insurance system are as follows:
- The first entity is the Health Insurance Authority, which is responsible for funding and providing medical services for patients and ensuring their care.
- The second entity is the Healthcare Regulation Authority, which oversees hospitals, medical units, and healthcare facilities.
- The third entity is the Accreditation and Healthcare Regulation Authority, which is responsible for monitoring the quality of healthcare services and granting licenses to medical
entities.
Talking about the advantages and disadvantages of universal health insurance, we first mention to you a list of the most important advantages as follows:
Comprehensive health insurance is characterized by the provision of comprehensive primary medical services, therapeutic and diagnostic services, pregnancy and reproductive care services, as well as first aid for emergency cases.
The State shall pay the costs of treating individuals at a small rate of bearing, in addition to paying the contributions of the unable and exempting them from material contributions to treatment.
The citizen's tolerance in radiology and analysis reaches a maximum of 10%, equivalent to 750 at a time.
The percentage of the citizen's contribution to the operations procedures does not exceed 5%, not exceeding EGP 400 at a time.
The deductible percentage in the costs of medicines and treatments does not exceed 10%, up to a maximum of EGP 1000 at a time.
In emergency cases, the citizen has the right to recover the material costs in the event of treatment outside the contracting parties.
Owners of tumors and chronic diseases do not bear any costs specific to treatment.
Until the implementation of the modern system of universal health insurance, citizens are entitled to benefit from the current health insurance system that exists in the governorates now.
In addition to the previous benefits, the citizen and his family receive additional benefits through comprehensive health insurance, such as:
Benefit from a family doctor and general practitioner.
Specialist doctors including dentistry and surgery.
Treatment, hospitalization, surgeries, and other types of treatment.
Obtaining imaging diagnostic radiology and laboratory tests.
Rehabilitation services and disbursement of prosthetic devices.
Dispensing medicines free of charge or with a tolerance not exceeding 10%.
Home treatment if necessary.
Travel for treatment abroad (according to the relevant regulations).
Dispensing medicines for tumors and chronic diseases completely free of charge.
To continue talking about the advantages and disadvantages of universal health insurance, here is a list of the most important disadvantages of universal health insurance as follows:
Slow implementation of comprehensive insurance in all governorates of the Republic.
Weak application due to the small percentage applied to it, which reaches 2% of the total population.
Health insurance has turned into a business where patients take care of financial burdens that they may not be able to afford.
Transforming government hospitals into a for-profit sector
In the event of an interruption of payment of the monthly contribution for comprehensive health insurance, the health insurance for children is forfeited.
The app is not comprehensive but optional.
Increasing the financial burdens on citizens.
Some healthcare services are not covered by health insurance, such as psychiatric treatment, mental health services, preventive healthcare, and diseases related to epidemics. However, the state covers the costs of these types of services that are not covered by health insurance.