35
History of the right in health insurance
Did you know that the labor project 10 years ago has been interested in providing health care for laborers that all big businessmen are obligated with, and that has been stated in the law of the working contract section 1944 issue no. 91 for the year 1959, and subject no. 65 from this law has stated that the work owner must provide workers with all the aid means in the construction or establishment.
The law has stated that if the number of workers in one place or in one town with a diameter of 15 km has exceeded 100 workers then the work owner should use or hire a nurse or a hospital attendant familiar with the means of medical aid to treat and care for them, and offer them the necessary medication, and all of this for free.
And if the number of workers has exceeded 500, the work owner should provide all the other means of medication in the cases that require assistance from specialized doctors, surgeries or any other treatment for free.
And if the worker have been treated in a governmental or charity hospital, the work owner must pay the hospital expenses (treatment, medication, accommodation), which can be defined according to the decision of the minister of the social affairs and work by mutual agreement with the minister of health.
1) On what base did the system of health insurance stand on?
The insurance legislator has used subject no. 65 of the law no. 91 for the year 1959 and on that base he made the system of health insurance issued in law no. 63 for the year 1964 because the decided medical care in the pointed to working law only includes a small number of workers, therefore it was necessary to make a system that guarantees medical services for all workers whenever the number of workers increase.
2) What are the decisions of health insurance for workers that the law has included?
-The health insurance decisions must be gradually applicable to the constructions and facilities that the minister issues decisions for, on the condition of continuing to apply the working law on the workers who don’t benefit from the decisions of health insurance.
-Keeping the acquired rights for workers.
-Caring for women when in the cases of pregnancy or nursing and guarantee their rights in medical care.
-The cooperation between workers and the work owners in financing health insurance in addition to the toll or tax that the patient pays which mustn’t be exhausting for the worker and must be suitable to his income.
The minister of health has issued the decision no. 858 for the year 1981 that the decisions of this insurance must be applicable to the workers in the constructions of the public and private sectors in all districts, that work in them between 5 and 499 workers.
Fanally the minister of health has issued the decision no. 353 for the year 1983 that the decisions of this insurance must be applicable to the workers in the constructions of the public and private sectors in all districts, that work in them between 1 and 4 workers, and lately the system of health insurance has been issued for school students in Egypt.
3) Who supervises and applies health insurance?
-The general assembly of health insurance for workers and people who take pensions.
-The general assembly of health insurance for students.
-A private assembly of health insurance for farmers.
And the ministry of health supervises all three assemblies and coordinates between them.
4) What are the deprived groups of this health insurance?
Small farmers and tenants of agrarian lands who suffer from deprivation of health care that social insurance guarantees for them, a lot has been said about improving health insurance to include all citizen groups, and there must be institutions to supervise and apply health insurance.
Therefore suitable decisions must be issued to guarantee health insurance for small farmers and tenants of agrarian lands, and the Land Center suggests some clauses and terms that guarantee this right for the small farmers and tenants of agrarian lands in Egypt.
The suggested system of health insurance for farmers must be applicable to the following groups:
-The temporary agrarian workers who are subject to the system of comprehensive insurance issued by the law no. 112 for the year 1970.
-The evacuation workers and tenants of agrarian lands.
-Agrarian land owners who own less than 5 feddans.
-People who take pensions of the mentioned groups.
5) Suggestions for financing the system of health insurance for small farmers, agrarian workers and tenants:
The money of this insurance consist of contributions from beneficiaries, agrarian land owners less than 5 feddans and the state (the treasury) in addition to the toll or tax that the patient pays suitable to his income when he benefits from this insurance.
6) What are the sides of medical care that the insured person benefits from?
The medical services that the general practitioner performs.
-The medical services that the specialists performs.
-Medical care at home when necessary.
-Treatment and accommodation at the hospital, sanitarium or the specialized center.
-Surgeries and other treatment types as the condition of the patient requires.
-Examination with the necessary radiography (rays), the laboratorial -researches and other examinations.
-Giving the necessary medication for all the above mentioned cases.
-Providing the rehabilitation services, artificial parts and compensatory machines.
7) The necessity of establishing an administration for the suggested system of health insurance:
The ministry of health must establish a general form of health insurance for farmers and handle the treatment of the insured people and care for them medically, and it must be related to the minister of health and population, and it must have its’ own budget within the states’ general budget, and the necessity of forming its’ administration board and defining its’ specialties as a decision from the Egyptian peoples’ council when presented by the minister of health and population that its’ administration board must consist of 4 representatives nominated by the general union for the syndicates of the Egyptian workers, 2 of them represent agrarian workers, small owners and tenants of agrarian lands and the cooperative union for agriculture.
The form handles the treatment of the patient and caring for him medically until he is cured, prove his disability or dies, and the form is relieved of taxes and tolls on all its’ operations including its’ investment operations.
8) What are the constituents of the suggested projects?
There are rural health units and central hospitals in stations and cities of the rural districts spread all over the country, and these units and hospitals are considered the basis for making the suggested insurance project on the condition of renewing the existing units and establishing a health unit for each village provided with the necessary modern medical equipments and frugal residences for doctors and nurses to encourage them to live in villages, and these units must offer medical care for the insured people and patients and give them medications.
When establishing these units the number of population must be considered, and these units must be on 2 levels:
The first level: specialization in the medical care that the general practitioner offers along with the rest of the specializations.
The second level: includes all specializations except for dental, eyes, specialized operations (surgeries), artificial parts and compensatory machines and rehabilitation services.
The referred to units are related to station hospitals and general hospitals in the districts after renewing them and providing them with medical equipments in all specializations, and treat cases of all specializations that health units don’t do including some specialized surgery operations, and provide rehabilitation services and artificial parts and compensatory machines.
9) How to apply the suggested project?
This suggested system can be applied step by step, either geographically or on the service level.
Decisions by the minister of health and population must be issued on the basis of a proposal of the form of health insurance for farmers to be applied on the districts that have fully equipped health units provided with all medical services, doctors and nurses.
And we can start with the health units that have the first level referred to and then the second level.
The right in health care and treatment is a right stated on in the Egyptian constitution and the international conventions for human rights, and we must demand the officials, the civil society foundations and members of the peoples’ and local councils to guarantee the rights of agrarian lands tenants, agrarian workers and small owners in health insurance in favor of citizens health for a country where everyone lives a decent and safe life.