<The Africa Report
By Fanny Rey
A first in a North African country: from now on all Moroccan citizens will benefit from a universal health care. In Algeria “things are different”, says the president of the national union of health specialists in the public health sector
IN MARCH, KING MOHAMED VI INAUGURATED MOROCCO’S AMBITIOUS REGIME D’ASSISTANCE MÉDICALE (RAMED), OR MEDICAL ASSISTANCE SCHEME/PHOTO/REUTERS
This month Morocco‘s King Mohamed VI gave the green light to one of the country’s most ambitious reforms. The country’s Regime d’Assistance Médicale (RAMED), or Medical Assistance Scheme, will benefit every Moroccan. It is the first in the North African region and the promise of a new era in the medical sector.The new health insurance scheme now covers all Moroccans, and not just civil servants and private sector professionals. It is a decision that comes to the rescue of about 28 percent of the population, that is 8.5 million people, with no insurance cover whatsoever and who are exempt from the compulsory medical insurance (Assurance Maladie Obligatoire, AMO). This portion of the Moroccan society comprises of rural dwellers, the self-employed, petty traders, and Moroccans in the informal sector.
“RAMED concretises measures laid out in the new constitution, and adopted on the 1st of July”, underlined El Hossein El Ouardi, the health minister.
About 4 million people living in extreme poverty will benefit from the health, which is free of charge. In big cities, Moroccans considered among the most vulnerable populations and who make between 3 767 and 5 650 Dirhams (between €338 and €507) per annum will pay annual contributions of 120 Dirhams or a maximum of 600 Dirhams per family.
Also read: Competition for Moroccan shoppers is toughening
There is a subtle difference between “vulnerable” and “abject poverty” in the rural areas, where criteria such as the exploitation of farmlands, the possession of livestock and farming equipment. The reform will also cater for 160 000 prisoners, the homeless and orphans into account.
This new scheme covers the same health programmes as the AMO and is available in all public health institutions. An initial budget of 2.7 billion dirhams was allocated to it.
Morocco’s new health scheme marks a big step forward that could see a wider emulation in the region. In Tunisia, a health programme similar to the Moroccan scheme is in the pipeline.
“There is political consensus on the project, what is left is to study the financial aspects,” indicated Khalil Ezzaouia, minister of Social Affairs, a fortnight ago. One minister said an identical health scheme could be implemented in Tunisia in about two years.
But in Algeria, “things are different” says Mohamed Yousfi, president of the national union of health specialists in the public health sector. “Every citizen can be treated in a public hospital with a symbolic contribution. The unemployed can have recourse to the community health initiative”.
The real challenge, according to him, is the development of contractual ties between social security and hospitals, which should help master health expenditure and insure a better access to health for all.
.
