Health insurance expert Abdul Monem Al-Shammam writes: Health Insurance in Libya Between Need and Necessity
With the worsening crises facing the healthcare sector in Libya and the growing pressures on the state budget, health insurance emerges as both a practical alternative and an urgent necessity to provide citizens with quality and efficient medical care, while ensuring their right to dignified treatment.
Accumulated Crises
Despite the government’s good intentions and the large public spending on the health sector, the reality reveals deep-rooted challenges. Abundant resources have not prevented weak performance, the availability of medicines has not translated into fair distribution, and the development of medical staff—though numerous—has fallen short of required standards. These imbalances have driven many patients to seek treatment abroad, especially in neighboring countries, at high costs that burden both citizens and the state.
According to economic data, government spending on health in Libya reached 4.65% of GDP in 2022, while per capita health spending amounted to only USD 278 annually. This reflects limited investment in such a vital sector. International reports also indicate that the health share of total government spending does not exceed 5.1%, down from about 6.9% in 2021, highlighting the declining priority given to this sector.
What is Health Insurance?
As experts explain, health insurance is a tripartite contract linking the insured citizen, healthcare providers (hospitals, clinics, and health centers), and insurance companies (or their mechanisms).
The system is based on regular financial contributions to a dedicated fund that later covers medical costs when needed. This ensures fairness in sharing burdens and sustainability of funding.
Benefits of Health Insurance
- Providing healthcare for all segments of society.
- Raising the quality of medical services under strict supervision.
- Reducing the financial burden on both the state and citizens.
- Adjusting contributions according to individual income.
- Addressing high treatment costs both domestically and abroad.
Conditions for Success in Libya
Experts believe that for health insurance to succeed in Libya, the right foundations must be in place, including:
- An effective health sector with modern infrastructure.
- Well-trained medical and technical staff.
- Efficient management capable of planning and organizing.
- A transparent, up-to-date health information system.
- Strict supervision of service quality.
- Citizen contributions to part of the cost to ensure sustainability.
Between Challenge and Hope
Amid economic challenges and budgetary pressures, health insurance is no longer a luxury but a necessity to ease the burden on the state and guarantee treatment for citizens. International experiences prove its success, but the real challenge lies in implementing it in a way that suits Libya’s realities and places citizens’ health at the top of priorities.
In upcoming articles, we will examine Libya’s health insurance experience in terms of realities and challenges, as well as shed light on the Health Insurance Law and its executive regulations—their advantages and the potential shortcomings they may face.
Figures and Statistics:
Some health sector figures for Libya in 2024:
- Total health expenditure: 9.07 billion LYD (~USD 1.88 billion), about 4.5% of GDP, compared to 7% in Tunisia, 5% in Egypt, and 8–12% in advanced countries.
- Health share of the state budget: Only 8%, compared to the international standard of ~15%.
- Distribution of health expenditure: 36% salaries, 16% operations, 17% subsidies, 0% for development or emergencies.
- Reliance on abroad: USD 389 million spent externally, including USD 101 million for treatment abroad and USD 288 million for medicines—20% of health spending in foreign currency.
- Healthcare workforce: 167,744 employees, 7.6% of total state employees, with a density of 23 health workers per 1,000 citizens (WHO minimum standard: 4.5).
- Wage bill: 3.275 billion LYD out of the total state wage bill of 67.6 billion LYD (only 4.85%).
- Average wages: Health employees earn 1,627 LYD monthly versus 2,560 LYD for general state employees—about 37% less.
- Low relative wages: Doctors earn 0.6 times per capita income (compared to 1.5–3 times internationally), nurses 0.6 (versus 1–2 internationally).
- Workforce imbalance: Shortages of nurses and technicians, excess administrators—leading to higher pressure and weaker services.
- Lack of investment and development: Infrastructure is under-equipped, heavy reliance on external sources for drugs and treatment consumes resources, while the health sector fails to provide adequate services or fairness for its workers.
