- 29
- Feb.
- 2024
Under normal circumstances, one should call it ‘the social engine.' However, the National Social Security Fund (NSSF) apparatus is no longer functioning the way it should. In fact, it was poised to become the first public victim of the financial crisis. But how did we even get there?
The history of the National Social Security Fund (NSSF) has always been turbulent, and not in a good way. It was unavoidable: hundreds of millions of dollars were circulating through its coffers every year, enough to pique the interest of even the most frugal."
To avoid delving too far back, let's begin with the showdown between Nabih Berri and Rafic Hariri in 2002, following the retirement of the former director. Hariri had his candidate, Ghazi Youssef, a former MP known for his integrity and expertise, while Berri put forward his protégé, Mohammad Karaki.
Berri's methods were well known: "You either accept my demands, or I'll obstruct the bills submitted by the government (Hariri’s)." And he got his way. Since then, a golden commemorative plaque from his sponsor has sat on Mohammad Karaki's desk.
Therefore, the consequence was inevitable: an upcoming era of decadence was set to start. Everyone, from policyholders to businesses and medical institutions (hospitals, etc.), has experienced the bitter outcomes. To sum it all up, here are the headlines:
* First of all, all efforts at transparency and efficiency improvement through computerization have proven futile. One of the most striking examples is the constant crowds gathering around messy counters, bearing packets of crumpled medication and prescriptions, trying to get reimbursed — perhaps in 6 months, 12 months, or never — at 80% of their value, maybe 40%, or nothing at all. It all depends on one’s luck.
* For the record, the World Bank (WB) launched an ambitious project of total computerization in the late 2000s. An initiative that encountered numerous obstacles set up one after another by the management of the fund.
The well-intentioned WB was still trying to find common ground until it was made clear to them that their project was rejected because "some data on the Lebanese working class might be leaked to Israel via the USA, which wields significant influence within the WB." Undoubtedly, the threat to our national security was enormous, as it entailed the risk of disclosing personal medical information, such as your neighbor Abu Antoun undergoing an appendectomy.
* On the other hand, the real reasons behind this rejection were well-founded. The daily operations of the NSSF Fund were rife with false invoices, fictitious companies, forged identities, fraudulent members, sham surgical procedures, fabricated expenses, and misleading statistics. At one point, this led to a staggering reported hospitalization rate nearing 20%.
* One of the ongoing criticisms is that the Fund has always privileged brand-name medications over cheaper generics and has refused to directly import medications in bulk. Such measures could have saved millions of dollars.
* All the preceding details explain why no external audit has been conducted on the accounts and operations of the Fund since 2010. Moreover, audit reports from 2006 to 2010 raised significant questions about potential fraud, mismanagement, and a recurring deficit in the healthcare sector (as per an investigation by The Public Source media).
* The management grew weary of these suspicions and prevented these inquisitive firms from poking their noses everywhere. Simultaneously, various oversight commissions, including the Board of Directors made up of employers’ representatives, employees, and the state, were sidelined. Therefore, the general manager became, de facto, the absolute dictator on board.
* In the meantime, the reckless management led to accumulating deficits in the healthcare branch. Especially as the Fund embarked on risky expansions with strong political undertones, creating healthcare funds for taxi drivers and optional members without any actuarial studies. The deficit grew year after year, prompting the management to dip into the Retirement fund, a move deemed unlawful. Hundreds of millions of dollars were thus transferred, with no prospect of recovery.
* It was only natural at this point to discover that as soon as the financial crisis erupted, the NSSF quickly began to falter. Moreover, the state, which already owed significant sums to the NSSF, stopped all payments. Consequently, there's no longer coverage for hospitalization, consultations, medications, or any other treatments. The few services it claims to cover are calculated at meager rates, which the service provider offsets with additional charges passed on to the patient.
As for the remaining approximately 1.6 million individuals who relied on the NSSF for their medical emergencies, they found themselves in dire circumstances. They joined the ranks of patients who depended on the Civil Servants' Mutual Fund or the Ministry of Health. However, this doesn't deter the inconsequential minister from occasionally flaunting his authority within his ministry.
Because, while in some cases you may find a remedy for your illness, there is absolutely no remedy for the sickness known as a puppet regime.
nicolas.sbeih@icibeyrouth.com
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