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Spending of the Ministry of Public Health

According to the public budget bill for the year 2012, the budget assigned to the Ministry of Public Health stood at LBP 554.48 billion (around USD 368 million), which accounts for a scanty 2.6% of the total public spending. The largest share of the Ministry’s budget is usually allocated for the hospitalization of the uninsured Lebanese in private hospitals and amounts to LBP 340 billion or approximately 61.3% of the total expenses. The provision of drugs ranks second on the Ministry’s agenda, with LBP 120 billion or 21% spent on medication. Together, the above items make up 83% of the Ministry’s total spending, equaling around LBP 460 billion.

In addition, the Lebanese, the uninsured particularly, can benefit from a number of contributions of which we mention:

  • LBP 13 billion allocated to public hospitals
  • LBP 10 billion allocated to joint programs with the UNICEF aimed at providing vaccines and medication
  • LBP 4.349 billion for the Lebanese Red Cross
  • LBP 4.875 billion for the Young Men’s Christian Association to provide medication for chronic diseases
  • LBP 200 million for the National AIDS Control Program
  • LBP 500 million for Caritas
  • LBP 500 million for the Imam As-Sadr’s associations
  • LBP 900 million for the Lebanese Union for the Physically Handicapped
  • LBP 100 million for the Association of the Martyr
  • LBP 300 million for the United Nations Population Fund (UNFPA)
  • LBP 85 million for the National Eye Bank Center
  • LBP 500 million for the National Organization for Organ and Tissue Donation and Transplantation
  • LBP 700 million assigned for joint programs with the Directorate General of Technical and Vocational Education and the Lebanese University.
  • LBP 160 million in support of the National Nursing Development Program
  • LBP 450 million for the Thalassemia Center
  • LBP 250 million for the Social Welfare Institutions/ Dar al-Aytam al-Islamiya
  • LBP 135 million for the Social Movement Association
  • LBP 220 million for the Mohammad Khaled Social Foundations
  • LBP 145 million for the Lebanese College for the Handicapped- Beit Shabab
  • LBP 70 million for the Greek Orthodox Nursing Home
  • LBP 55 million for Dar As-Sadaqa in Zahle
  • LBP 145 million for the National Center for Development and Rehabilitation
  • LBP 70 million for the Saint George Medical Center
  • LBP 55 million for the Tal-Chiha Nursing Home
  • LBP 200 million for the Childhood Protection and Care Association
  • LBP 2.450 billion for vaccination programs
  • LBP 2.750 billion for the primary healthcare program (Dispensaries)
  • LBP 550 million for the Medical Awareness Program

A portion of the Ministry’s expenditure goes to:

  • Office supplies: LBP 110 million
  • Administrative supplies: LBP 810 million
  • Liquid fuels: LBP 200 million
  • Laboratory supplies: LBP 250 million
  • Pesticides: LBP 400 million
  • Communication: LBP 500 million
  • Electricity and water: LBP 475 million
  • Office rent and maintenance: LBP 1.217 billion
  • Advertising and publications: LBP 807 million
  • Services and cleaning: LBP 250 million
  • Salaries and wages: LBP 26.957 billion
  • Expenses of the inoperative central laboratory: LBP 1.055 billion
  • Technical equipment: LBP 2.1 billion
  • IT equipment: LBP 1.5 billion

The beneficiaries of the Ministry’s donations are estimated at approximately 1.9 million Lebanese, which brings the share of each individual to no more than LBP 242,000 annually, a meager portion compared to the high cost of hospitalization in Lebanon.

National Social Security Fund

The number of the Lebanese covered by the NSSF amounts to 1,335,505 people distributed as follows:

  • The insured: 593,508 members
  • The beneficiaries or dependants: 728,944 members
  • The optional subscribers: 12,756 members

The medical services of the NSSF reached LBP 626.1 billion in 2011 and were distributed as follows:

  • Services to the insured members: LBP 460.685 billion
  • Services to taxi drivers: LBP 75.438 billion
  • Services to specific segments: LBP 18.630 billion
  • Services to optional subscribers: LBP 26.315 billion
  • Administrative expenses: LBP 45.03 billion

Military Healthcare

The military health insurance covers members of the Lebanese armed forces, their dependants, which total approximately 500,000 people, and the prisoners detained by the military forces. The healthcare costs of the above amount to LBP 379.625 billion annually and break down as illustrated in Table 1.

Distribution of health care spending by military apparatus (Amounts in billions of LBP)

Table 1

 

Medications and laboratory materials

Sickness and Maternity Care

Hospital care

Health care in dispensaries and medical centers

Total

Lebanese Army

46.9

25.8

130

2

204.7

Internal Security Forces

16.8

20

72.5

10

119.3

General Security

4

8.5

13.215

LBP 950 million

26.7

State Security

1.940

2.3

3.5

LBP 775 million

8.515

Customs

1.05

4

5.4

LBP 400 million

10.85

Detainees in military prisons

4.5

-

5.060

-

9.56

Source: 2012 draft budget law

Ministry of Social Affairs

An amount of LBP 193.7 billion is earmarked annually by the Ministry of Social Affairs to assist non-governmental organizations. The share of health care is estimated at approximately LBP 65 billion, assigned mainly to provide medication and to cover tests and check-ups at the Ministry’s centers or at the centers of those organizations engaging in contracts with the Ministry.

The beneficiaries of this type of assistance are those who lack health insurance and seek coverage at the expense of the Ministry of Social Affairs. The health and hospitalization costs borne by the Ministry are detailed as follows:

  • Joint social and healthcare projects with NGOs: LBP 9 billion
  • Allocations to development services centers: LBP 18 billion
  • Contribution to Caritas Lebanon: LBP 400 million
  • National Substance Abuse Prevention Program: LBP 100 million

Solidarity Funds

The 2012 draft budget law also allocated LBP 53.7 billion for the solidarity funds set up by the government to assist in hospitalization and education. It is known that the members of these funds contribute to their expenses, noting that around 30,000 people benefit from their contributions. These funds are:

  • MPs Solidarity Fund: LBP 13 billion
  • Solidarity Fund for the Parliament Staff: LBP 1.6 billion
  • Solidarity Fund for the Lebanese University Teachers: LBP 23 billion
  • Judges Solidarity Fund: LBP 10.5 billion
  • Solidarity Fund for the Judges of Islamic Religious Courts: LBP 5 billion
  • Solidarity Fund for Judicial Assistants: LBP 600 million

State Employees Coop

The State Employees Coop offers health and education coverage to both serving and retired public employees and teachers. The system of benefits covers around 400,000 people and the Coop’s spending on health alone amounts to LBP 175 billion.

Conclusion

The Lebanese state spends, along with the contributions of the private sector to the social security fund, an approximate LBP 1823 billion on healthcare and hospitalization as detailed in Table 2.

State spending on health

Table 1

Provider of Healthcare

Amounts

(LBP billion)

# of beneficiaries

Ministry of Public Health

554,48

1.9 million

National Social Security Fund

626,1

1.33 million

Solidarity Funds

53,7

30,000

State Employees Coop

175

400,000

Ministry of Social Affairs

65

-

Military Healthcare

379,6

500,000

Total

1853,88

4.16 million

Source: 2012 draft budget law

Problem and Solution

While the Lebanese state spends approximately USD 1.2 billion annually on healthcare, 51% of the Lebanese people have only access to the coverage of the ministries of public health and social affairs with a negligible individual share not exceeding LBP 300,000. This requires a reconsideration of the entire healthcare system by unifying medical offerings and services, standardizing medical tariffs and limiting the coverage services within the jurisdiction of one health provider in order to reduce costs. If costs are to be kept at their present rates, full coverage for all the Lebanese, whether hospitalized or not, is the least to be expected in return.

Distribution of Funds to Private Hospitals in Contract with the Ministry of Public Health

According to the 2013 draft budget law, the Ministry of Public Health set the financial ceiling for the admissions it subsidizes to both private and public hospitals at LBP 420 billion (USD 280 million) distributed as follows:

1- Private Hospitals: LBP: 225.7 billion (USD 150 million)

Hospital Amounts in thousands of LBP

Beirut Mohafza

Al-Makassed 4.703.500
Saint George Hospital 3.600.000
American University of Beirut Medical Center 4.400.000
Hotel Dieu de France 3.300.000
Rizk Hospital 1.650.000
Haddad Hospital for the Rosary Sisters 750.000
Geitawi Lebanese Hospital 3.400.000
Islamic Nursing Home 450.000
Nawfal Clinics 1.100.000
Najjar Hospital 300.000
Clemenceau Medical Center 300.000
Beirut Eye Specialty Hospital 300000
Total 24.252.500 (USD 16 million)

Mount Lebanon Mohafaza

Baabda

Sacré Coeur 2.200.000
Saint Charles Hospital 1.900.000
Hôpital Sainte Thérèse 1.200.000
As-Sahel Hospital 4.000.000
Al-Zahraa Hospital 5.500.000
Al-Burj 1.200.000
Maarbes 450.000
Al-Hayat Hospital 2.400.000
Great Prophet Hospital 6.000.000
Bhammen 3.200.000
Mount Lebanon Hospital 3.000.000
Medical Rehabilitation Specialist Center 125.400
Saint George Hospital, Hadath 450.000
Al-Jabal Hospital 1.100.000
Total 32.725.400 (USD 21.7 million)

Matn

Beit Chabab 400.000
Saint Joseph Hospital 2.500.000
Eye and Ear Hospital International 313.500
Abou Jaoude 650.000
Serhal 750.000
Al-Hayek 727.320
Hôpital Psychiatrique de la Croix 400.000
Haroun 1.600.000
Middle East Institute of Health 1.200.000
Libano-Canadien 1.128.600
Bellevue Medical Center 1.650.000
Al-Sharq 2.400.000
Al-Mashreq 1.460.000
Bhannes 800.000
Sach Medical Sarl (Bitar) 300.000
Total 16.279.240 (USD 10.8 million)

Chouf

Ain W Zain Hospital 7.770.000
Al-Othman (Mazboud) 727.320
Eqlim’s Medical Institute 1.000.000
Baaqline Hospital 858.000
Total 10.355.320 (USD 6.8 million)

Aley

Al-Iman 1.056.000
Al-Watani 957.000
Al-Irfan 1.050.000
Kamal Jumblat Hospital- Medical 2000 1.050.000
Lebanese Ophthalmic Hospital 438.900
Bshamoun Specialty Hospital 500.000
Total 5.051.900 (USD 3.3 million)

Kessrouan

Hopital Monseigneur Cortbawi 300.000
Hopital Notre Dame du Liban 1.850.000
Hopital Saint George- Ajaltoun 1.800.000
Saint Louis 400.000
Total 4.350.000 (USD 2.9 million)

Jbeil

Hopital Notre Dame Maritime 1.200.000
Centre Hospitalier Universitaire- Notre Dame de Secours 5.500.000
Total/ Jbeil 6.700.000 (USD 4.5 million)
Total/ Mount Lebanon 75.462.040 (USD 50 million)

North Mohafaza

Tripoli

Islamic Charitable Hospital 6.000.000
Mounla Hospital 3.000.000
Nini Hospital sal 3.730.000
New Hospital Mazloum 1.700.000
Chahine 550.000
Al-Hanan 950.000
As-Salam 1.300.000
Elissar 440.0000
Dar el-Chifaa 1.500.000
Tripoli 19.670.000 (USD 131 million)

Mennieh- Dennieh

El-Kheir 1.200.000
Mennieh Hospital 300.000
Total 1.500.000 (USD 1 million)

Akkar

Akkar Rahal 2.350.000
Notre Dame de la Paix 1.241.000
El-Youssef Hospital Center 4.200.000
Total 7.791.000 (USD 5.2 million)

Koura

Al-Koura 1.550.000
Al-Haykaliyeh 4.000.000
Borgi 650.000
Total 6.200.000 (USD 4.1 million)

Zgharta

Saydet Zgharta 2.100.000
Centre Hospitalier du Nord 6.100.000
North Medical Treatment Center 630.000
Total 8.820.000 (USD 5.9 million)

Batroun

Al-Batroun 2.328.000
Total/ North Mohafaza 46.309.000 (USD 30.7 million)

South Mohafaza

Saida
Labib Medical Center sal 4.764.380
Dalla’a General Hospital 1.050.000
Hammoud 8.504.400
Al-Janoub Hospital (Shuayb) 1.800.000
Qassab 550.000
Health Medical Center 1.653.000
Total 18.321.780 (USD 12.1 million)

Tyre

Jabal Amel 5.000.000
Hopital Libano-Italien 2.850.000
Alaeddine 2.500.000
Al-Raii Medical Center 2.400.000
Hiram 900.000
Kharroubi General Hospital 1.650.000
Total 15.300.000 (USD 10.7 million)

Nabatieh

Ragheb Harb 2.000.000
Ghandour 1.000.000
Secours Populaire Libanais 1.400.000
Al-Hekmi 614.460
Total 5.014.460 (USD 3.3 million)

Bint Jbeil

Bint Jbeil Hospital 1.500.000
Total/ south Mohafaza 40.136.240 (USD 26.6 million)

Beqa’a Mohafaza

Rashaya

Bahmad 649.800

Zahle

Tal Chiha 3.000.000
Khoury General Hospital 3.325.000
El-Beqa’a 2.500.000
Libano-Francais 2.900.000
Riyaq 4.600.000
Riyaq 300.000
Chtoura 2.750.000
Total 19.375.000 (USD 12.9 million)

Western Beqa’a

Dr. Hamed Farhat Hospital 1.600.000
Doctors Hospital- Manara 500.000
Sohmor 600.000
Total 2.700.000 (USD 1.8 million)

Baalbeck

Dar el-Hikmah 3.700.000
Al-Mortada 2.000.000
Rayan 1.740.000
Tatari 700.000
Dar Al-amal University Hospital 5.000.000
Universal Hospital 450.000
Total 13.590.000 (USD 9 million)

Hermel

Dar el-Tawlid Hospital 1.000.000
Batoul 900.000
Ibn Sina 1.200.000
Total 3.100.000 (USD 2.06 million)

Chtoura

Taanayel General Hospital 110.000
Total/ Beqa’a Mohafaza 39.524.800 (USD 26.2)

Source: Decree no. 10033 dated 6-3-2013

2-Public Hospitals: LBP 94 billion

Hospital Amounts in thousands of LBP

Beirut Mohafaza

Rafic Hariri University Hospital 26.000.000
Karantina 1.300.000
Total 27.300.000 (USD 18.2 million)

Mount Lebanon Mohafaza

Baabda University Hospital 2.640.000
Dahr el-Bashek Governmental Hospital 4.750.000
Dahr el-Bashek (Detox) 700.000
El-Chahhar el-Gharbi 1.600.000
Sibline 2.700.000
Al-Bwar 2.000.000
Total 14.390.000 (USD 9.5 million)

North Mohafaza

Orange-Naso 1.000.000
Tripoli’s Governmental Hospital 4.400.000
Tannourin’s Governmental Hospital 3.300.000
Sir el-Dennieh’s Governmental Hospital 3.300.000
Ehden’s Governmental Hospital 275.000
Dr. Abdullah Rasi Governmental Hospital 3.300.000
Bsharris Governmental Hospital 800.000
Total 16.375.000 (USD 10.9 million)

South Mohafaza

Saida’s Governmental Hospital 4.300.000
Jezzine’s Governmental Hospital 600.000
Nabatieh’s Governmental Hospital 6.000.000
Nabatieh (Pet Scan) 2.500.000
Nabatieh 2.000.000
Mays al-Jabal’s Governmental Hospital 2.200.000
Marjeyoun’s Governmental Hospital 2.800.000
Hasbaya’s Governmental Hospital 1.700.000
Bint Jbeil’s Governmental Hospital 1.650.000
Tebnine Governmental Hospital 2.300.000
Total 26.050.000 (USD 17.3 million)

Beqa’a Mohafaza

Elias Hrawi’s Governmental Hospital 3.000.000
Baalbeck’s Governmental Hospital 3.750.000
Hermel’s Governmental Hospital 2.200.000
Rashya el-Wadi’s Governmental Hospital 1.100.000
Total 10.050.000 (USD 6.7 million)

Source: Decree no. 10033 dated 6-3-2013

3- Chronic illness medical centers and institutes: LBP 14.559 billion

4- Centers for irreversible paralysis and disabilities: LBP 728.4 million

5- Centers for cerebral palsy and chest diseases: LBP 1.294 billion

6- Centers for reversible paralysis and disabilities: LBP 4.490 billion

7- Coma treatment centers: LBP 2.8 billion

8- Mental disorders’ centers: LBP 12.655 billion

9- Hearing and speech centers: LBP 680 million

10- Prostheses centers: LBP 805 million

11- Centers providing hearing devices and aids: LBP 205 million

The total funds distributed to the above centers (from 3 to 11) amount to LBP 38.2 billion



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