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Informal politics and inequity of access to health care in Lebanon

Bradley Chen and Melani Cammett*

International Journal for Equity in Health 2012, 11:23  doi:10.1186/1475-9276-11-23

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commenting on some information

Hassan H. Dib   (2012-08-09 10:24)  Medicose Health Net Inc. email

<p>There are many true facts and many facts are still absent in this article. The Lebanese society is a very complex one. A person has to live there to understand and comprehend the whole picture about the health care system in Lebanon. The authors should have listed at the beginning of the article those insured by: <br/> <br/>1. the social insurance (Caisse-Mutualle) (1.2 Million receive out of the 3.5-4 million Lebanese); <br/> <br/>2. Insured by private insurance; <br/>3. Insured by religious organizations (already the authors mentioned this from political point of view); <br/> <br/>4. Professional Societies, Orders, and Association such as the Lebanese Order of Physician, the Lebanese Order of Engineering, etc,. The rest who do not have medical insurance coverage they are instantaneously covered by Ministry of Health. <br/> <br/>The sample does not provide the real representation of the Lebanese population because: <br/> <br/> <br/>1) from the data, the majority fall within the low education and unprofessional people. <br/>2) Professional people are underrepresented in this article even though they consist of at least 1/3 of the population. <br/> <br/>3) It is true what the authors mentioned that if you do not belong to a certain party you have less chance to receive subsidizes (but not free) for hospitalization within their hospitals; nevertheless, if the patients have insurance coverage with any type of insurance the patients are always welcomed. For example if the patient is Muslim from any sect and wants to be hospitalized in Hotel- Dieux hospital, Rizk hospital, American University hospital, even Shi' it hospitals has the ability to enter regardless of one's sect and religion. It is not political more than it is cultural and sectarian issue. It depends where the patient feels comfortable within her/his own community. <br/> <br/> <br/>4) The authors should have listed the percentage of the population who lack any type of insurance coverage, and then build their analysis and discussion to observe if it is really the health care service is politically dominated. <br/> <br/>5) Impoverished population still have accessibility to hospitalization to any hospital (many hospitals contracts with the Lebanese MOH and provide beds). A patient to be able to be hospitalized on the account of the Lebanese MOH one has to present that he/she lacks any coverage with the social insurance organization (Caisse-Mutualle), provide a copy of Lebanese ID and a doctor prescription requiring the patient to undergo treatment and/or surgery. It is true the patient has to pay a bit to the doctor (even though by law prevent the doctor from asking for any fees); however, physicians are forced to do so because the MOH do not pay doctors only after two years for their fees. <br/>The authors mentioned: “patients are hospitalized based on their enrolment each to a certain party and that the head of the party call the hospital administrator to admit the patient”, it does happen, but not as the authors picture it in their article. There are separate incidences; however, MOH ends up paying the bills or it sharing the payments.</p>

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