ITIC MEA 2024 | Egyptian healthcare – system overview and cost containment challenges
Dr Reham Salama Elshinnawy, Dr Asaad M Riad, and Dr Ahmed Monir discuss the healthcare options available to tourists in Cairo and the Red Sea resorts
The ITIJ team have been reporting live from ITIC MEA in Cairo this week (April 2024) sharing the discussions that took place at the conference. Read all the reports here.
Dr Reham Salama Elshinnawy, Director of the International Patient Department, Egypt Healthcare Authority, started our first session at ITIC MEA 2024 by outlining that in Egypt there are four main healthcare sections: the private sector, university hospitals, military hospitals and police hospitals.
She said that operational excellence comes from infrastructure, patient experience, digital transformation, billing, governance, and taking care of healthcare workers.
Dr Elshinnawy went on to talk about how important digitalisation is, and that features (such as electronic health records, telemedicine, telepathology and teleradiology) are now all vital to their operations.
An audience member then queried whether telemedicine is permitted by the Egyptian authorities. Dr Elshinnawy explained it is permitted from doctor to doctor, but not patient to doctor. She said that hopefully by the end of the year patient/doctor telemedicine will be allowed in Egypt.
Dr Ahmed Monir added that as a country, the Egyptian healthcare infrastructure needs to improve.
Mandy Langfield, Director of Publishing and ITIC moderator, asked how the relationship can improve with the international community. Dr Elshinnawy replied that they provide quality, value-based healthcare. That everything is fully documented and the service is up to date. They are also trying to make things practical for dealing with international insurers and that their hospital staff are well trained, which helps with dealing with international patients.
Dr Asaad M Riad, General Manager, Egypt In-Touch Assistance, next took to the stage, and said we must learn from the past.
He considered whether healthcare in Egypt is expensive, and said that US per capita healthcare spending is over twice the average of other wealthy countries.
The problem, he said, is that providers for healthcare for travellers could be the issue. The relationships between insurers, hospitals and patients are complicated and unhealthy.
He said patients don’t usually know if they have insurance and that hospitals try to negotiate when a patient attends. Then insurers look at the hospitals like thieves.
He said that insurers and hospitals must work together closely and try to collaborate. Dr Assad added that both sides need to reimagine the relationship – that they are allies not opponents!
He stated that it’s cheaper to find a doctor in Egypt with a good medical facility rather than repatriation.
Dr Asaad went on to talk about what’s wrong with the current system, and said that the problems lie with:
- Availability – doctors working in hotels don’t want to stay there, they find it hard to progress
- Sustainability – tourism fluctuates
- Communication – nobody cares about setting up good communication channels
- Uncertainty – people should come to see the facilities in the country
- Missing local experience – insurers and patients expect that facilities will be the same as their home country.
He went on to say it’s now important to look to the future, and that it is imperative to always communicate. He added that it is important to:
- Be aware of cultural sensitivity and understanding – find information suitable to clients
- Be on top of quality control – auditing should implemented
- Support good practice – if you find a good doctor with good practices, use them
- Enable fast and fair payment
- Invest in more healthcare.
A question came from the audience as to how travellers can be made more aware about insurance. Dr Assad said to use digital solutions for those who have bought insurance as part of a package – an SMS message could make patients more aware. It can be simple communication.
Dr Ahmed Monir, Founder of LGA Group, LGA Group, started his session by outlining the main tourist destinations in Egypt, and said the Nile river, the Pyramids of Giza, Cairo, the Valley of the Kings, Aswan, Abu Simbel and Luxor are the main destinations.
He said that in 2021 there were 8.2 million visitors to the region, and that increased significantly to 14.9 million in 2023.
He then went on to talk about the roadblocks into insurance payor’s struggles in Egypt, saying they include:
- Overpricing
- There is no channel for reporting malpractice
- They are forced to pay
- Lack of knowledge about the healthcare landscape
- Three types of fee structure per nationality
- Lack of patient direction control
- Lack of transparency
- No feedback mechanisms or tools
- Excessive profit margins
- Fake cases.
Dr Monir then spoke about the challenges faced by providers in Egypt, and said they include:
- Mixed apples – there are some bad apples in the industry
- High rental costs of clinics and hotels
- Lack of trust that makes insurance companies act aggressively
- Delaying payments of insurance companies
- Bad behaviour of local assistance
- Moving patients from hotels to clinics
- Lack of win-win situation
- Differentiated categories of policies and premium.
He said there needs to be action plans in place to help with the issues.
He said providers hesitate to engage with local agents or assistance organisations, suspecting excessive deductions from their invoices. Finding people you trust is the most important aspect.
Also, he added, it is important to know about the involvement of intermediaries such as tour guides and taxis with vested interests, leading to commission-driven practices. He noted that it was important to make sure you meet with the chief tour guide and to be aware of providers providing unnecessary supplements, treatments, and medications – exploiting both patients and insurers alike.
Dr Monir finished by saying that it is time to distinguish the rotten apples from the ripe ones.