In the second of three segments on the cost of health in Lebanon, we will explore the issue of hospitalization at the expense of the National Social Security Fund and the Civil Servants Cooperative.

The National Social Security Fund (NSSF)


The end-of-service indemnity plan, the family allowance plan and the sickness and maternity plan constitute the three active plans of the NSSF. In this issue, we are concerned with the latter.

Sickness and maternity plan

There are 433,592 people enrolled in the sickness and maternity plan. However, inclusive of beneficiaries (husband, wife, father, mother and children), this number adds up to 1.2 million, or one third of the country’s population of 3.6 million citizens.

Revenues of the plan are generated from subscription fees paid by employers and employees, as well as governmental contributions and interest revenues. In April 2001, the subscription fee decreased from 15% to 9% of the income of those enrolled (given that it does not exceed LL 1.5 million), with employers assuming 7% of the fee, while employees bear the remaining 2%.

The government’s share is 25% of the cost of the plan, estimated at LL 90 billion ($59.7 million) for the year 2002. The plan’s revenues and expenses over the last few years are illustrated in Table 1.

A considerable increase in the cost of medical care can be seen for the years 1997-2001, amounting to LL 145 billion or $96 million (equivalent to 80%). This can be explained by the increase in the number of beneficiaries of the hospitalization plan, as well as an increase in medication prices and a rise in the cost of medical services.

The number of hospitalization cases and their duration are depicted in Table 2, which shows that real daily inpatient costs have increased from LL 237,000 to LL 336,000, a 42% increase in four years.

The Civil Servants’ Cooperative


Falling under the Council of Ministers, the cooperative is a governmental agency that funds public sector employees and their dependents’ hospitalization, as well as their children’s education.

The cooperative’s main resources originate from government contribution, taken into account in the annual budget, along with the 1% charge from employee salaries (similar to the 6% charge for pension fund purposes).

The number of those enrolled in the cooperative reaches approximately 60,000 employees, along with 200,000 beneficiaries. Its expenses and coverage are listed in Table 3.

Although a decrease can be noted in the overall cost of healthcare in 1999, as shown in Table 3, this is not an indicative figure since the cooperative was not paying the private hospitals.