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Who Benefits from Public Healthcare Subsidies in Egypt

Direct subsidization of healthcare services has been widely used in many countries to improve health outcomes. It is commonly believed that the poor are the main beneficiaries from these subsidies. We test this hypothesis in Egypt by empirically analyzing the distribution of public healthcare subsidies using data from Egypt Demographic and Health Survey and Egypt National Health Accounts. To determine the distribution of public health care subsidies, we conducted a Benefit Incidence Analysis. As a robustness check, both concentration and Kakwani indices for outpatient, inpatient, and total healthcare were also calculated. Results show some degree of inequality in the benefits from public healthcare services, which varied by the type of healthcare provided. In particular, subsidies associated with University hospitals are pro-rich and have inequality increasing effect, while subsidies associated with outpatient and inpatient care provided by the Ministry of Health and Population have not been pro-poor but have inequality reducing effect (weakly progressive). Results were robust to the different analytical methods. While it is widely perceived that the poor benefit the most from health subsidies, the findings of this study refute this hypothesis in the case of Egypt. Poverty reduction measures and healthcare reforms in Egypt should not only focus on expanding the coverage of healthcare benefits, but also on improving the equity of its distribution.