With a liberal health system and highly qualified doctors, the majority of health care is provided by the private sector. 80% of beds are in private hospitals, concentrated in the capital and Mount Lebanon (>45%) and largely dependent on public funds (64%). Over-equipped, hospitals are no longer able to provide care, as they no longer have the means to maintain their equipment due to the crisis and lack nursing staff (3/1000 inhabitants), drugs and medical devices. Health expenditure of US$ 4 billion in 2017 is financed up to 44% by households (share of “out of pocket”, one of the highest in the world) which devote an average of 12% of their expenditure to it, with inequality of access to care and nearly 50% of the population without health coverage.
The challenge is to respond to the health emergency and the financing of care and to propose an overhaul of the care system that is sustainable in the Lebanon of tomorrow.
In the short term, request for assistance from France to set up an international crisis unit under the aegis of the UN and the World Bank to deal with the shortage of medicines and consumables and to provide support for equipment maintenance. To alleviate the lack of nurses and prevent the exodus of young doctors, offer subsidies and training in France in return for a commitment to work for 5 to 10 years in Lebanon.
In the medium to long term, in the event of the emergence of a new political governance, revise the health map by strengthening the place of primary care in health centres and the role and missions of the Ministry of Public Health (based on the organisation of the directorates of the Ministry of Health in France – DGS, DGOS – and the High Authority for Health.
Proposed solutions (continued)
Create a quality and efficiency of care body. Introduce a pathway medicine that is efficient in terms of impact on the health status of the population in relation to the dollars spent per Lebanese.
Create a Health Insurance Fund with expanded coverage by merging the current funds to cover primary health risks and high risk and maintaining supplementary insurance for other care. To build a health database to support epidemiological and public health studies for the evaluation of therapeutic strategies and health policies.
Rely on scientific research as a lever for transformation with collaborations between CNRS Lebanon and CNRS/ANR/AFD.
Pursue digital health projects (teleconsultations, telecare) by transforming them to put medical excellence back at the service of the country’s economic development (for surrounding countries and Africa).
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