The Origins of Compulsory Health Insurance (AMO)

Prior to the introduction of compulsory health insurance, healthcare cover for workers covered by the Labour Code was provided by the Health Protection Scheme, with an employer’s contribution rate of 2 per cent.

This scheme had been provisionally established by the Malian legislature through Law No. 62-68/AN-RM of 9 August 1962 on the Social Security Code, which stipulates in Article 39(2) that ‘Every employer must ensure that their employees have access to a medical service which provides them and their families with healthcare pending the establishment of a health insurance scheme.’

The benefits of this ‘Sickness Protection’ scheme were provided through the Inter-Company Medical Centres (CMIE) which the National Social Security Institute had opened or contracted with across the country.

As regards civil servants, the situation was characterised by the absence of any formal medical cover scheme. Consequently, civil servants who fell ill received treatment at health centres within their departments, where such centres existed. Others paid for their own treatment or, in serious cases, requested medical evacuation.

The scope of the Compulsory Health Insurance (AMO) scheme has been expanded compared with the previous sickness protection scheme, as the AMO broadens the scope of the former scheme in three respects:

In terms of those covered, which is no longer limited to workers covered by the Labour Code but also includes civil servants, military personnel and members of parliament.

In terms of service providers, which are no longer limited to CMIE centres but now include all health centres contracted by the National Health Insurance Fund.

In terms of healthcare services, which now cover all outpatient and inpatient care, with the exception of cosmetic treatments, optical care and dental care.