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Tunisian Health Care System: Financing Mechanisms / Major Problems -…
Tunisian Health Care System: Financing
Mechanisms / Major Problems
Typology of health care expenditures and payments
Sum of Total health expenditure
Public health expenditures
Direct payment of household in health t
Capital formation
Current health expenditures
Total health expenditures estimated at 7.1% of the GDP : too low
Strategic Directions
Direction 3: Improving the efficiency of the system in the context of accessibility to
quality care and respect for patient safety
Direction 1: Definition and implementation of the strategy for the UHC through a
consultative process and implementation step
Direction 2 : Increase public spending on health
MAJOR PROBLEMS
Indirect costs
Transportation
Direct household payments
The incidence of catastrophic spending and impoverishment is highest in poor regions
==> Aggravation of inequalities
Chronic deficit of public health structures
increased needs and development of the public sector
dependent on political demand
A brake on performance through the capping of CNAM's packages
Constraints on public service missions without a corresponding counterpart
Lack of a system efficiency strategy
Fragmentation of the 3 streams
Increased inequity of access among the socially insured.
Development of a two-speed medicine
Different modalities of care depending on the channel to which they belong