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Strengthening the Health Insurance Regulatory Framework in Egypt

2007–2010 || U.S. Agency for International Development

Abstract

Through USAID’s multi-sectoral $125 million Technical Assistance for Policy Reform II (TAPR II) project, Deloitte helped the Government of Egypt (GOE) strengthen the legal and regulatory framework that supports its health insurance sector. Overall, TAPR II aimed to provide a consolidated source of technical assistance - as well as related training, grants, and reform support - for economic policy formation and private sector development. The health insurance reform aspect of the project supported the GOE in promoting and regulating the private health insurance industry by providing training aimed at private health insurance companies, drafting the private health insurance law, and strengthening the capacity of the Egyptian Insurance Supervisory Authority (EISA) to regulate the market. The project also provided technical support to the Ministry of Health with drafting the social health insurance law with the aim to increase coverage to all Egyptians and curb costs.

The Challenge

The private health insurance sector was already active and operating for years in Egypt without any regulation and had created many practices that did not conform with leading practices and international standards. On the other hand, the social health insurance sector only provided coverage to half the population and was financially dependent on state subsidies. The challenge in both cases was creating regulation that would take into account current economic, political and social practices while meeting international leading practices.

How We Helped

Deloitte assisted the Egyptian Ministry of Health (MOH) and the Egyptian Insurance Supervisory Authority (EISA) in drafting the social health insurance law and the private health insurance law respectively. Deloitte also facilitated public presentations and media workshops in order to educate the public and facilitate stakeholder buy-in. These efforts resulted in the legal framework for the government-sponsored laws and helped secure support from private health insurance companies in the case of the private health insurance law. In addition, Deloitte provided EISA with tools to help strengthen its regulatory role in the areas of supervisory capacity, adequacy of laws and regulations, training, and building capacity for supervision of private health insurance companies and managed health care organizations.

Specifically, the Deloitte team supported the MOH and EISA through the following activities:

  • Analyzing insurance legislation and making recommendations for modifications
  • Drafting the proposed health insurance laws and related executive regulations
  • Providing recommendations on collection of data from health insurance providers to create standards
  • Establishing the Egyptian Insurance Institute to provide training and continued education for licensing and certification
  • Providing training for both EISA and private health insurance companies
  • Facilitating communication between the MOH and EISA to clarify EISA's role as a supervisor and MOH's role as the regulator for health-related quality issues
  • Completing the EISA web portal to facilitate access to information and services through five modules (i.e., public interface, content management system, online complaints, online registration, online submission of insurance and pension fund reports)
  • Leading EISA's conversion from a compliance-based examination system to a risks-based supervision approach to include developing and implementing the transition strategy, planning and implementing organizational restructuring activities, and sponsoring training and internships for EISA staff to improve their technical skills and gain insight into how other regulators inspected and supervised the industry

Solution

Deloitte's involvement with TAPR II left the GOE with an inclusive legal regulatory framework, a more effective EISA, and the tools and training to allow it to develop for decades to come. Deloitte's support in improving these structures allowed the GOE a more stable base from which to grow its health insurance sector, and ultimately increase access to quality health care services to its people.

As used in this document, ‘Deloitte’ means Deloitte Consulting LLP, a subsidiary of Deloitte LLP. Please see www.deloitte.com/us/about for a detailed description of the legal structure of Deloitte LLP and its subsidiaries. Certain services may not be available to attest clients under the rules and regulations of public accounting.

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