Expanding Health Insurance in Morocco
By the end of 2021, health insurance in Morocco covered 11 million citizens. With the final count of covered citizens, the Moroccan government announced its expansion of health insurance to unconsidered sector workers. The number of protected citizens will grow in 2022 as proposals are under review to expand health insurance to uncovered workers, such as artisans, taxi drivers, farmers and more.
Morocco’s Health Insurance System
Morocco’s health insurance system is a mixture of government-run and privately owned insurance businesses. Most in Morocco have coverage through the primary source of health insurance. This is the Mandatory Health Insurance, L’Assurance Maladie Obligatoire (AMO).
Morocco implemented its first health care policy in 1959 and established free health services in the public sector. After 1959, the Moroccan health care system went through various changes. However, in 2005, it established and stabilized with the implementation of new programs to regulate and differentiate between the private and public health insurance systems.
In 2005, the Moroccan government created a mandatory, payroll-based health insurance plan that increased coverage from 16% of the Moroccan population to 30%. The payroll-based system is the AMO. The AMO covers the costs of general medicine and medical and surgical specialties, pregnancy, childbirth and postnatal care, laboratory tests, radiology and medical imaging, optical care, oral health treatment and paramedics.
The Regime d’Assistance Medicale (RAMED)
The second insurance policy that Morocco implemented is the Regime d’Assistance Medicale (RAMED). RAMED is a public, government-financed program to fund insurance for those living in poverty and without the income needed to access the AMO.
The private insurance sector, which people often choose simply due to availability, is a system based on a fee-for-service policy. For whatever the service may be, private insurance requires the individual to pay a minimum of 20% of the fees due. However, fees sometimes range as high as 50%.
Morocco’s health insurance system guarantees free care to anyone. However, it is specifically free for anyone living in poverty at any clinic that Morocco’s government runs, as long as the clinics obtain a certificat d’indigence. Thankfully, the poverty rate in Morocco is as low as 3.6%. However, health care remains concentrated in the cities leaving the rural population without easy access to health care.
The rural population often remains uncovered and without the funds to be a part of the private insurance operations. The impending health insurance expansion promises to cover the rural workers. This will ease the economic burden of health insurance from their income.
Impending Expansion of the System
The expansion to cover more workers is not the first one the government has made since 2019. In 2020, the Moroccan government expanded its health insurance system to cover all costs, for every citizen, for COVID-19 treatment. The treatment coverage is available through the AMO.
Morocco’s health insurance system will expand pending the implementation of six drafted policy proposals. The overarching plan for Morocco’s health insurance system is to generalize all health insurance for uncovered workers. The first step in this plan is the creation of coverage beginning with the farmers in the outlying reaches of Morocco, the taxi drivers in the cities and the artisans spread around the country.
The Need for Health Insurance in Rural Communities in Morocco
Morocco’s rural and farming areas are often unconsidered, with doctors and clinics needing to open in said rural areas. The average salary of a Moroccan farmer is 11,700 Moroccan Dirham (MAD) per month, which translates to slightly more than $1,200.
Unfortunately, since the AMO did not cover the farmers, the farmers were often unable to afford private insurance due to having little income to spare. Therefore, with the flexibility of the cost of services due, the farmers could not risk paying anything that might exceed their income.
The Single Professional Contribution System (SPC)
The farmers are only one of the groups that will benefit from the expanded insurance availability. The Moroccan health insurance system’s expansion also covers artisans, who are part of the Single Professional Contribution system (SPC). The SPC allows workers reliant on a flat rate of income to pay fixed taxes and receive health insurance under the new expansion.
The workers who are part of the SPC do not have high incomes and often live on less than the living minimum wage. Much like the farmers, the AMO would not consider them, leaving them unable to afford the private insurance system.
The Moroccan health insurance system’s expansion allows access to basic health care that many could not access before. The government is increasing the annual amount spent on health care as well. The private and public systems will receive additional funding to hire more doctors. Hopefully, more clinics will open in the rural areas to help these newly insured farmers and rural dwellers.
The Moroccan health insurance system will help both the individual and the public. Expanded health insurance could reduce debt, both health-related and non-health-related. It could permit more opportunities to spend money in the local economy.
Increased economic flow can increase income and wages for all business sectors, including the lower-paid individuals, like the farmers. It can also decrease the poverty rate and the number of individuals at risk of poverty.
– Clara Mulvihill