The generalization of the Plan for medical assistance to economically disadvantaged ( RAMED ) is a priority of Houcine El Ouardi, the new Minister of Health. He just said that executives of his department are working hard to implement this generalization should have been effective since December 31, 2011 last.
Supposed to start in November 2006 after the launch of the AMO, then postponed again, before a first pilot project is launched in the region of Tadla-Azilal, the RAMED continues to stimulate debate and arouse some doubts about its actual implementation and efficiency.
Particularly regarding the question of eligibility for benefit. Indeed, the Decree No. 2-08-177 of 28 Ramadan 1429 (September 29, 2008) implementing the provisions of Book III of Law No. 65-00 concerning the medical assistance program provides in Articles 3 and 4 that the person applying to the medical assistance program "must have, in urban areas, the quality of residents in a municipality whose poverty rate, calculated on the basis of poverty indicators defined by the High Planning Commission, is greater than or equal to 30% and it has an annual income of less than 5,650 dirhams per person. " If the person in question resides in rural areas, it "must have a score heritage, calculated on the basis of all the elements that constitute its assets less than or equal to 70 per person in the household and have a score of socioeconomic conditions , calculated on the basis of variables related to living conditions of the household, less than or equal to 6. "
Some observers believe that these criteria are vague and imprecise. For them, the application of RAMED may well raise the issue of targeting the state's hard to solve with his Caisse de compensation . They fear that the poor who are supposed to primarily benefit the RAMED are affected by relative to other more stable economically, in terms of access to quality care.
The composition of committees permanent premises, responsible for electing beneficiaries RAMED was also questioned. Observers close to these instances the proliferation of players and the vagueness of their role in such proceedings. Indeed, these committees chaired by a boss and composed of one representative from the Ministries of Health, Interior, Finance, of Agriculture and National Mutual, the president of the municipality and the representative of the President council of the prefecture forced several questions about the value of the presence of some departments such as the Agriculture or the National Mutual Aid in this device. The presence of President of the municipality does not, too, unanimously.
Observers wondered about the ability of these components to work together and if they are well equipped to carry out their mission and whether they have the ability to provide viable information on applicants to the scheme. Because there are doubts about their ability to maintain files containing information on reliable and proven relevant.
For many observers, only mokaddems remain a viable source of information, but often unreliable under the various fraudulent practices which undermine the normal functioning of their action. For them, their presence is certainly crucial in the successful startup of the system, but it is still necessary that it be well supervised and especially preceded by a vast operation of moralization of their action. Their proximity to people and their local knowledge will enable them to properly conduct the investigation and verification process information report ed by the concerned.
Another problem, not least, key human resources dedicated to the operationalization of this device. Several sources have shown concern about the lack of well-trained and expected to perform this task.
For some, it looks tough, because in each prefecture, only a handful of officials mobilized to process hundreds of files in record time.
Some believe that the mission will be impossible given the complexity of conducting surveys, checking the information collected, data entry and computer processing. Better still, the very quality of the composition of these groups also says a lot about the ease with which the issue of RAMED was treated.
The new health minister will he considered these comments or merely there to take note, like its predecessor, the predictable failure of a device with so many Moroccans are anxiously awaiting the implementation?
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