Clinics are struggling to make their revolution
The opinion of the Competition Council on clinics and similar establishments (hemodialysis, radiotherapy, chemotherapy centers, etc.) is timely. “Major reforms in the health sector are underway, in particular through the generalization of compulsory health insurance coverage (AMO) by the end of 2022”, notes the entity chaired by Ahmed Rahhou.
Regulation will also change mode, and a high health authority will be created, not to mention the Code of Basic Medical Coverage published on November 30, 2022 in Official Gazette No. 7147 bis. The Competition Council took the matter on its own motion to analyze “the competitive functioning of the medical care market”. Due to a lack of data, the Council first commissioned a research firm (not mentioned in the opinion) to conduct a field survey. A sample of 30 clinics and 10 similar institutions was chosen out of the 389 existing ones. The regulator then interviewed about twenty organizations, such as the Ministry of Health, the tax authorities, or the CNSS (National Social Security Fund), and the professional associations of clinics, paramedics, and other professions.
General observation: “the market has been very dynamic in recent years. On the other hand, dysfunctions prevent it from fully playing its role in the development of the national health system”.
Clinics are “major players” in the medical care market. There are 389 of them, unevenly distributed across the national territory. The establishments provide one third of the hospital bed capacity. The law on the practice of medicine has relatively propelled the investment. The capital of the clinics was opened to non-practitioners. Clinics represent the largest third-party payment expenditure item for the AMO compulsory medical insurance. However, a geographical imbalance persists.
The Competition Council refers to “the obsolescence of technical and quality standards”, which poses a serious risk to 36 million patients. Nonetheless, a case that gives hope stands out: “Non-profit clinics are a driving force for developing the market…”, namely the polyclinics of the CNSS, the hemodialysis centers created by philanthropic sponsors, or the university hospitals launched by foundations. About 26 non-profit clinics do exist. They are in a “limited” number, but with a “significant” bed capacity: 91 beds on average. Even with higher fees, nonprofits remain “attractive to patients.”
The owners of private clinics cry out for “unfair competition” in view of the more favorable tax regime granted to their challengers.
Isn’t entrepreneurship risk taking? Private clinics claim “the reinvestment of their profit” in the development of their structures, training, research….
The Competition Council announces a clarification: “The market is experiencing a quantitative and qualitative evolution of the share capital” with the arrival of the investment funds. A certain “ transparency ” thus replaces the “financial opacity” which used to prevail in this sector.
Faiçal FAQUIHI
