Health insurance and medical deserts: The case of Morocco
DOI:
https://doi.org/10.62438/tunismed.v104i09.6742Keywords:
health insurance , coverage , access to healthcare , medical desertAbstract
Introduction: Universal health coverage is a key objective in Morocco. However, it faces significant imbalances in the distribution of resources. The study explores ways in which these imbalances can be addressed.
Methods: The study adopts a mixed-methods approach, combining quantitative analysis using principal component analysis with an examination of concentration, and qualitative analysis through a review of the legislation governing health insurance.
Results: The PCA reveals a strong correlation between the nine healthcare provision indicators (coefficients ranging from 0.804 to 0.992), with a KMO index of 0.709, confirming the suitability of the data. Two axes account for 96.37% of the total variance, one corresponding to the overall level
of healthcare provision and the other contrasting public and private provision. The factor map shows six under-resourced regions. At the provincial level, Gini indices >0.5 indicate severe inequalities in distribution, with all values exceeding the 0.5 threshold that characterises critical inequality.
Discussion: The Moroccan health insurance system has an equity objective but contains no explicit territorial provisions; governance is centralised and Article 1 prohibits any discrimination based on area of residence. Fiscal incentives for private investment in underserved areas are low (0.5% of tax expenditure in 2024). International approaches exist, but their implementation in Morocco faces technological, financial and governance obstacles.
Conclusions: There are multiple levers that health insurance can mobilise, starting with positive discrimination in favour of insured persons residing in these regions.
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