title: Could the employment-based targeting approach serve Egypt in moving towards a social health insurance model?
abstract: The current health insurance system in Egypt targets the productive population through an employment-based scheme bounded by a cost ceiling and focusing on curative care. Egypt Social Contract Survey data from 2005 were used to evaluate the impact of the employment-based scheme on health system accessibility and financing. Only 22.8% of the population in the productive age range (19-59 years) benefited from any health insurance scheme. The employment-based scheme covered 39.3% of the working population and was skewed towards urban areas, older people, females and the wealthier. It did not increase service utilization, but reduced out-of-pocket expenditure. Egypt should blend all health insurance schemes and adopt an innovative approach to reach universal coverage.
authors.affiliation: Social Research Center, American University in Cairo, Cairo, Egypt. shshawky@aucegypt.edu
authors.forename: S
authors.initials: S
authors.lastname: Shawky
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D004526:Efficiency; D004534:Egypt; D005260:Female; D005382:Financing, Personal / Q000706:statistics & numerical data; D005544:Forecasting; D006264:Health Benefit Plans, Employee / Q000458:organization & administration*; D018166:Health Care Reform / Q000458:organization & administration; D006297:Health Services Accessibility / Q000458:organization & administration*; D006302:Health Services Research; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017146:Models, Organizational; D009313:National Health Programs / Q000458:organization & administration*; D015397:Program Evaluation; D018709:Statistics, Nonparametric; D019472:Universal Health Insurance / Q000458:organization & administration*