Lebanon’s health care reform aims at tackling corruption

Sunday 31/07/2016
A Lebanese doctor treats a woman with respiratory difficulties at the emergency room at Sacré Coeur hospital outside Beirut, Lebanon.

Beirut - The Lebanese were pleas­antly surprised when the government approved a plan extending free health care coverage to people 64 years or older. The cur­rent system limits coverage to 85% of the hospital bills.
The decision was welcomed by a population that expects little from a Lebanese government renowned for corruption and incompetence.
However, it was surprising how little attention the plan received in the media. In the West, health care is a prominent issue on which elec­tions are won or lost. In Lebanon, public interest is directed more to­wards divisive political issues.
While this is no “mini-Obamac­are”, it remains a plan that affects about 55,000 elderly Lebanese at an estimated annual cost of $10 mil­lion. Minister of Public Health Ali Hassan Khalil said he would finance the plan by cracking down on cor­ruption in the health care system.
Despite the efficiency of its ser­vice, the Lebanese health care sys­tem remains flawed and corrupt. It is common for some private hospi­tals to overcharge the government, including billing for phantom pa­tients. Recently, one hospital was discovered to be charging the gov­ernment for services to patients af­ter those patients had died.
Hospitals, on the other hand, complain that the government delays settling invoices on the grounds of verification. Some in­voices submitted in the year 2000 are yet to be paid.
But will the new plan work? Ex­perience calls for scepticism. On two occasions, the government attempted to introduce a compre­hensive health care plan but both attempts failed.
On one occasion, the government invited the public to subscribe to a plan that offered full coverage to all regardless of age. Some did sub­scribe but then discovered that the plan existed on paper only. The oth­er attempt was when parliamentar­ians introduced a health care bill to parliament offering comprehensive coverage. That was more than 15 years ago. Nothing has been heard of the bill since.
It is vital for the latest plan to work. Its success may have a rip­ple effect on the country and could help bring the divided population of Lebanon together.
Regardless of their sects, political orientations and conflicting loyal­ties, all Lebanese need a feasible health care plan but such a plan must be the product of public de­bate and not the decision of a min­ister or even the cabinet. Ministers and cabinets come and go and pri­orities change.
A meaningful debate over health care not only could improve the new plan, it could also lead to public consideration of other issues, such as schooling, taxation and housing. A series of debates over multiple issues of social significance will go a long way towards creating a har­monious community and reducing political tensions.
Moreover, if the new plan suc­ceeds in cracking down on corrup­tion in the health care system, as promised by the minister, this may encourage the government to intro­duce badly needed reforms in other sectors.