This article was automatically translated from HIBAPRESS, the Arabic version:
Hibapress
The Economic, Social and Environmental Council (EESC) recommended the establishment of a unified compulsory system based on the principles of solidarity, complementarity and convergence between the different health insurance schemes, while reinforcing it with a system of additional coverage (complementary and optional) under the mutual sector and/or private insurance.
During a meeting dedicated to the presentation of the conclusions of the Council’s opinion on the theme “Generalization of the AMO, progress report: social progress to be consolidated, challenges to be met”, the president of the EESC, Ahmed Reda Chami underlined, Wednesday in Rabat, that this opinion aims to ensure effective medical coverage for all, while preserving the balance of the financial situation of households and ensuring the sustainability of the health insurance ecosystem. basic compulsory (AMO).
He indicated that the generalization project of the AMO represents an unprecedented social performance in the contemporary history of Morocco, noting that this structuring project aims to extend the benefits of health coverage to all citizens, as well as the residents on the national territory.
Mr. Chami highlighted, in this sense, the remarkable progress made, in a short time, to achieve this objective, indicating that approximately 86.5% of residents are currently registered with the health insurance plan, compared to less by 60% in 2020.
He added that the continued development of the legal framework and technical infrastructure has enabled all citizens to have access to medical coverage, especially since the management organizations have also engaged in this virtuous dynamic with speed and the required efficiency in the processing of health records.
The results turn out to be “positive and the progress is really tangible”, he welcomed, emphasizing, moreover, a good number of challenges which were addressed in the Council’s opinion and presented by the stakeholders. and experts solicited in this regard, who deserve particular attention to ensure the optimal success of this project.
The EESC president explained that to date, 8.5 million citizens still cannot benefit from this protection, because they are not registered in the insurance system (around 5 million), or they are even s They are registered in a situation of “closed rights” (3.5 million).
And to emphasize that the percentage of health expenses borne directly by the insured can reach 50% of total expenses, a percentage which, according to him, remains high compared to the capped rate of (25%) recommended by the World Health Organization. health (WHO) and the World Bank. This situation forces certain policyholders to refrain from using basic care for financial reasons, he noted.
Among the most significant recommendations presented by the Council with a view to completing the effective generalization of AMO, in accordance with the High Royal Guidelines and the provisions of the framework law relating to social protection, is the fact that registration for The AMO must be a compulsory procedure for all, while removing the situation of “closed rights” and ensuring the diversification of the sources of financing of the AMO, among others.
It also involves improving access to medicines by revising the legal framework for rationing and pricing, while strengthening and protecting national production of generic medicines.
The Council also called for improving the reimbursement rate for expenses linked to medical procedures and consultations in general, as well as strengthening medical control of expenses by developing and diversifying the number of binding care protocols for organizations managing the AMO and health professionals, while involving qualified actors in this dynamic.
