How Did Social Insurance in Egypt Become a Problem Rather Than a Solution?

On 31 March 2015, Egypt’s Minister of Transitional Justice announced that the committee for legislative reform was working on a draft decision to amend some provisions of the laws currently regulating social insurance. Not much attention was paid to this announcement, in which plenty of other projects were mentioned. Over the past decade, little attention has been paid in general to social insurance in Egypt, despite the significant relationship between its inefficiency and increasing poverty. 

Imagine the following scenario: Umm Mohammed’s husband worked as a janitor in a Gulf country. He passes away, leaving behind children who are still at school. The newly widowed Umm Mohammed, a housecleaner has to take her kids out of school so they could help her work and try to make ends meet. Before the accident, they were managing. Now, they are just below the poverty line. Many face the same risks as poverty is Egypt’s major social problem. More than a quarter of the population is poor in absolute terms. As in other countries, the spread of poverty in Egypt has many reasons. One of them is the high vulnerability of many households to social shocks. Many families have fallen into severe poverty only after social risks occurred. Typical social risk groups like women-headed households or the disabled are over-represented among the poor, despite the country’s wide range of highly developed protection systems. Indeed, what ought to save Umm Mohammed from this or ease her way is social protection. Social protection systems are institutionalized mechanisms that help individuals manage social risks or cushion their impact once they occur. They are systems that are governed, administered, or at least initiated and monitored by the state, and can include social and health insurance as well as public social transfer systems (social assistance and subsidies).

The focus here will be on social insurance, which is employment-based and financed by contributions from workers and employers. This system is often not well-known and does not arouse much interest, although it is one the most crucial social policy schemes: it provides insurance against risks or contingencies through risk-pooling. In other words, it is a form of strong social solidarity, where reciprocity is key. One day you are covered, the next you cover.

As we will see, social insurance in Egypt relies on a complex and fragmented system that has long been in place, but is often inefficient and unattractive for both workers and employers, and has become increasingly ill-adapted to society, given Egypt’s political economy. Social insurance is highly reflective of the existing fracture between state and society, a fracture that actually took root in the 1970s and was revealed by the January 25 Revolution, when people demanded that the authorities take into account their unfulfilled needs for bread, jobs, and social justice.

Social insurance is originally meant to be a solution to people’s vulnerability, but due to years of inertia and lack of adjustments, it has become more of a problem in Egypt, in many ways. This is illuminated by studying the evolution of the system since the Nasserite era.

Nasser and the Ambition of Universal Coverage 

The first Egyptian social insurance scheme was established by decree in December 1854. It only benefited a small group of permanent civil servants, whose pensions were financed through public revenue. After July 1952, the Free Officers and new government began to extend social insurance coverage to all civil servants, as well as public and private sector workers, using funds allocated independently of the state’s general budget. Such a social insurance scheme was introduced in August 1955. This new law, law number 419 for 1955, provided benefits and protection, which include health insurance and employment compensation for all workers, to this can be added the old age pensions as well as the death and disability compensations [1].

Under Gamal Abdel Nasser, social protection became governed by the ambition of universal coverage. The aim was to cover all employees of both the public and private sector. This is very reflective of Nasser’s intention of being recognized by all Egyptians and of building a mass social base, alongside the security apparatus he was also constructing. This manifested itself in a different way in the repressive state-apparatus that the Egyptian state was to embody.[2] Corporatism and co-optation were traits underlying many of the institutions, policies and laws of this era. With this hegemonic structuring “members [are] directed harmoniously by a brain that is lodged in the leadership of the regime.”[3] And so it was for social insurance. Indeed, in order for everyone to pledge allegiance to the state, and hence Nasser, social insurance had to cover as many people as possible. Nasser’s state was “constantly increasing distributive rewards, thus co-opting groups”[4] and in return was creating a broad constituency. His Egypt was being recognized as the provider of first resort.[5]

This ambition of universal coverage was also aligned with Nasser’s “Arab socialist” policies. This Nasserite social insurance scheme parallels his famous “from the needle to the rocket” slogan of developmental nationalism. Just as post-liberation Egypt could produce and modernize, post-liberation Egypt could also help and hospitalize. As Joel Beinin describes, Nasser promoted “state-led development, agrarian reform, import-substitution industrialization, and social benefits for workers and white-collar employees in a greatly expanded public sector.”[6] The state-led socioeconomic policies that Nasser implemented, among which was the establishment of a national social insurance scheme, aimed at creating a new inclusive contract between the state and the masses, an objective that was mentioned as a priority in the 1962 National Charter.[7]

These social services were first instituted by the Permanent Council of Public Services, which was formed in October 1953.[8] Then, in 1965, the social insurance system was extended to cover private sector employees through the Saving and Insurance Establishment, which became the General Insurance Establishment in 1959. This last institution was changed to the Social Insurance Organization in 1964, for employees in state-owned companies and the private sector. The year 1963 saw the creation of the Pension Insurance Organization which regulated social insurance for government employees. It was the state budget that made possible the realization of social insurance. The two pension organizations collected contributions and distributed benefits in return. 

The Paradoxes of the Sadat Era: Covering and Exposing

With the arrival of president Anwar Sadat in the 1970s, social insurance took a new form. Egypt opened its doors to foreign investment in what is known as the Infitah policies: liberalization and free-market became the new mottos of Egyptian authorities. The socialist principles and policies of Nasserism, among which were free education, social equality, growing public employment, abolition of feudalism and progressive taxation, were partially or completely reversed. The emerging educated middle-class made up of doctors, teachers, engineers, journalists and lawyers working for the government or para-statal institutions started suffering from the decay of an increasingly low-paying public sector. Egypt witnessed a shift from paternalist authoritarianism to neo-liberal authoritarianism. The original Nasserite social contract was buried and so was the universal ambition of social insurance.

The prevalent social insurance laws passed under Sadat were then quite paradoxical: on the one hand, they reflected the old aim of universal coverage and protecting equally the whole population; on the other hand, they reflected the new directions of the Egyptian state which led to social insurance taking the form of fragmented laws and government regulations, covering different segments of population. The laws’ very communication to the people took on a new form, one that was dry and distant, emphasizing the institutionalization of social insurance. In addition, ministries, hence governmental institutions, became directly involved in regulating and supervising social protection, replacing the initial organizations that used to enjoy some distance and independence from the state. The budget was no longer that of the entire public revenue, meant for the entire society, but rather a small portion of it.

Thus extension of coverage became an even stronger priority in the 1970s, but with disparate means of implementation. A number of laws related to social insurance were issued in order to extend the scope of coverage to almost all Egyptians, to define procedures, mechanisms and institutions and regulate contributions and benefits. This gave birth to the current complex and stratified system, administered by the National Social Insurance Organization (NSIO) and fragmented between four main schemes defined by four corresponding laws. 

First, law 79 of 1975 defines the general and most comprehensive scheme, which covers government employees from the age of 16, and public and private sector employees from the age of 18. Coverage is mandatory, which means that the government and public and private companies are required to affiliate their employees. Every insured person is entitled to different kinds of benefits, as follows:

- Old-age, disability and survivor[9] pensions that amount to 2.2 percent of the average monthly income (base and variable) multiplied by the number of years of contribution (up to thirty six years), provided that the insured person has contributed for a certain amount of time (at least 120 months for old-age, at least three consecutive months or at least six months in total for disability and survivor pensions);

- Unemployment benefits equivalent to sixty percent of the last salary up to sixteen weeks (or twenty eight if the employee contributed at least twenty-four months);

- Sickness benefits equivalent to seventy-five percent of the last salary during three months and 85 percent for three additional months, provided that the insured person contributed for the last three months before sickness for at least six months in total;

- Workplace injury benefits that amount to one hundred percent of the salary from the day after the injury occurred until the employee can get back to work or is declared permanently disabled. In that case, the employee receives eighty percent of his average monthly wage the year before the injury or in case of partial disability, a percentage of the benefit calculated according to the assessed percentage of disability.

- Maternity benefits equivalent to seventy-five percent of the salary for three months (up to three children) provided that the employee contributed for the ten previous months (three more months can be taken off work, but are unpaid). 

The scheme is funded through contributions of employees and employers, while the state adds a very symbolic proportion. Contributions are paid on both the variable wage, with a cap, decided for by the government, at 987 EGP, and the base wage, with a cap of 1590 EGP.[10] Total contributions amount to forty-one percent that split into forteen percent of the base salary and eleven percent of the variable salary for employees, twenty-six percent and twenty-four percent respectively for employees, and around one percent for the State. These levels of contributions are among the highest in the world.

To further extend the scope of coverage, law 108 of 1976, law 50 of 1978 and law 112 of 1980 were issued and defined the three other main schemes. They respectively cover employers and self-employed persons, migrant workers and temporary and seasonal workers. This last law, also known as the Universal Social Security Scheme, was actually meant to provide coverage to workers in the informal sector and hence create a universal system, covering the whole population. The insured are only entitled to old-age, disability and survivor benefits. For the first two groups, those benefits also amount to 2.2 percent of the average monthly salary (or a self-declared revenue for migrant workers and self-employed persons, comprising between 150 or 2100 EGP maximum). Employers and self-employed contribute fifteen percent of their salary monthly, and migrant workers contribute 22.5 percent. Seasonal workers have to buy a 1 EGP stamp each month at a local NSIO branch and are entitled to fixed pensions of 450 EGP a month.

These policies, and the new focus on economy and investment, were maintained under Sadat’s successor Hosni Mubarak without any subsequent redefinition of the relation between state and society. Liberal economic reforms entailed structural changes within society, but were not followed by any appropriate and significant adjustment of social policies, and in particular social insurance, to this new reality. For instance, up until the 1991 Gulf War Mubarak had put off responding to the IMF and World Bank’s calls to reduce the subsidies and privatize the public sector. This however changed following Egypt’s role in the Gulf War. The latter “prepared the way for a new agreement with the IMF in May 1991” which encouraged Mubarak’s government to privatize and “in 1995 the regime drafted a new Unified Labor Law that proposed to reorganize the national labor federation, eliminate the job security (emphasis added) gained by public-sector workers in the Nasir era.”[11] Under both Sadat and Mubarak, social insurance reflected this growing fracture between state and society, and the laws placed a significant burden on employees for contributions, while social and economic inequality began to increase. Egypt was left with an unfair system, with inherent flaws and low actual coverage.

Consequently, certain social groups became more and more marginalized. To begin with, the informal sector comprises forty percent of the Egyptian labor force. This means that this percentage of the population along with their families are left out of protection. Furthermore, even the “formal” laborers do not see an amelioration in their access to social insurance. Indeed, in 2006, less than 10 percent of the labor force within the private sector was insured.[12] And, with the latter’s expansion, it is easy to see that many were also left without coverage. In addition, the benefits that the insured received did not suffice to shield, cover or insure them, because they did not keep up with the pace of inflation. What reflects this lack in coverage and protection is the out-of-pocket expenditure on health, or private expenditure on health. According to the World Health Organization, private expenditure on health was measured at seventy-two percent in 2014. This rate has been stagnant since the 1980s. This has pushed many into poverty. Moreover, the contribution rate, set by law 112 of 1980, only increased the already existing social inequalities and helped sustain the inequitable distribution of income.  For instance, the contribution rate of an employee earning 1000 EGP reached the average of 12.5 percent of his salary, while another, whose earnings were 10,000 EGP, only spent 2.2 percent on the contribution.[13] With alienation came indignity. 

The Current System: Low Coverage, Social Evasion and Structural Injustices 

Despite the system’s official ambitions to reach universal coverage, in 2013, the number of insured persons was 16.8 million,[14] compared to a labor force of 27.3 million, which means 61.5 percent. In 2006, it was 66.4 percent and in 2002, 90.6 percent. Actual coverage is low, and has continued to decrease during the last decade. In particular, only thirty-five thousand migrant workers were registered in 2013, while the total number of Egyptians working abroad is estimated to be ten million, which means that the Egyptian system is either unknown or unattractive to them. Besides, only 951,917 seasonal workers were registered in 2013, while informal employment is estimated by the World Bank to represent forty percent of total employment in Egypt. 

One of the reasons why coverage is low and social insurance is not as efficient as it was planned to be is that it has various inherent flaws that create negative incentives for workers and employers to participate.

As has often been highlighted in the literature, the high social insurance contribution rates requested from both the employers and employees, combined with weak enforcement of law, encourages employers and employees either not to participate in the social insurance system[15] or to contribute with amounts that are lower than their actual wage.[16]

Many employees cannot afford to contribute if they want to survive on a daily basis, because of poverty. Poor households cannot afford to save future consumption when their daily earnings hardly cover their immediate consumption needs. An example – among many – of this is provided by Maïa Sieverding in her article A Life Course Perspective on Social Protection among the Working Poor in Egypt. She interviewed a twenty-six year-old worker in a print shop in Cairo whose response was: 

“He [my employer] wanted to insure me, but I refused because it will deduct 14 percent from my salary. My base salary is 1000LE, so if he deducts 14 percent it will be 140LE, and those 140LE will make a difference for me – I am a man getting ready for marriage and those 140LE, if I went into a gam‘iyya [ROSCA] with them they’ll make something...so it’s not the time for it [i.e. insurance].”[17]

As for the employers, recent data is unavailable, but figures from the Ministry of Insurance in 2003estimated that thirty percent of private companies did not pay contributions for their employees (either all or some of them only). Due to the low enforcement of labor laws, companies are free to reduce their employees’ protection while increasing their own profits. As Maïa Sieverding notes:

Violations of labor law are widespread, and reportedly included lack of contracts and social insurance registration, under-reporting of salaries to social insurance, attempts to pay employer’s social insurance contributions from employee’s salaries, arbitrary salary reductions, deductions for sick days, and requiring employees to sign undated official resignations, effectively forfeiting their rights in case of dismissal.[18]

Maïa Sieverding also mentions the fact that many workers do not understand what social insurance is and how the system works. They are often unaware of their labor rights and of the social insurance benefits they could be entitled to. They do not know how many months of contributions are required to be able to get a pension, nor the amount of the pension they could actually receive and sometimes do not even know about their contribution rates. This makes it easier for employers to abuse their employees and make them bear the whole cost of contributions or to convince them that insurance is not worth its cost.

In other words, the system is faced with a significant social evasion phenomenon and provides very few incentives for poor households to participate in social protection, which in turn severely hampers its assigned poverty alleviation function. By failing to reach the poor and the most vulnerable workers, while mainly reaching groups that already enjoy relative privileges on the labor market (formal workers, in the public or private sector), social insurance can actually contribute to increase existing inequalities, hence compromising its primary mission. 

Moreover, the general scheme (law 79/1975) shows a structural injustice related to the cap that limits the maximum pensionable salary: low-income workers, earning less than the cap, pay their contributions on their whole salary, whereas those whose salaries are above the cap only pay contributions on the capped portion of their salary. The consequence of this is twofold: first, low-income workers have an incentive to declare a salary lower than it actually is so that they pay lower contributions; second, removing the cap could help the system gain non-negligible resources by collecting higher contributions from high-wage workers. In 2010, law 135 was passed and aimed at reducing employee contributions and removing the cap on pensionable salary. It also defined a minimum pension provision, making all citizens over sixty-five eligible for a pension (fifteen percent of the national average wage). This law could have been a first step in improving the system’s efficiency and in providing actual safety nets to those in need. It should have been implemented by January 2012, but was not, due to the disruption of power that happened after the revolution. It was finally cancelled by the presidential decree 79 of 2013 which was passed under president Adly Mansour.

Finally, coverage is reflective of existing inequalities, between generations, categories of workers and genders. According to the 2006 Egypt Labor Marker Panel Survey, the most recent comprehensive labor market study to date, the affiliation rate is rather high within the cohorts that benefited from the expansion of public employment and were hence automatically affiliated to the social insurance system during the Nasser era and the beginning of the 1970s. But this rate is much lower for the youngest cohorts, which relates to the decline in public employment and the expansion of informal labor[19] that resulted from it.[20] As a result, the coverage is much higher among wager workers than it is among the self-employed. In 2006 for instance, the percentage of those contributing was 58.95 percent for the wage workers while reaching only 22.04 for the self-employed, hence three times less.[21] Meanwhile informal laborers enjoy no protection at all against work-related risks. Women’s coverage is quite low as well, as is the penetration rate in rural areas: rural workers and families are frequently the forgotten element of public policies in Egypt and many of them fall through the social security system's net.

Fostering Individualism Rather than Social Cohesion

The flaws of the system go beyond these structural shortcomings, contradicting the very objective of social cohesion that should be at its core. The reason for this is that the system relies on a Pay-As-You-Go (PAYG) defined benefit pension plan. This PAYG system can be described as follows: it is partially funded; and retirement benefits are determined by the years of work and the salary of the employee. With this system, contributions are made by the workforce and used to pay for the benefits of the currently retired. Though this could suggest the creation of some strong social solidarity between different generations, workers and pensioners, the societal element is still lacking. Indeed, this PAYG scheme is guilty of sustaining some inequities.

First, through this scheme, the level of protection is defined by the earnings and wealth of each person: as we saw benefits are defined according to the average monthly salary. Hence, higher income workers are entitled to high level of benefits and protection, while lower income workers enjoy less protection due to smaller benefits. Yet, if protection depends on earnings, calamities do not adjust themselves to income. 

Second, this PAYG system is ill-adapted to the case of demographic shifts: the contributions made by the workforce pay for the benefits of the retired, but leave future retirees uncertain about their own benefits. This is because the system might become financially unstable in case of demographic transition since population ageing and the diminution of the birth rate brings us to a smaller workforce[22]: fewer workers are paying for the benefits of an increasing number of retirees, who tend to live longer than before. If at some point, the workforce becomes too small, retirees and future retirees might not be able to receive the pension for which they contributed. Yet, if there is a shift in demographics, meaning in society, the social contract or the protection scheme should also be reflective of it.

In light of this, the distance between people and state and even among people themselves is widened. Each person is encouraged to look after his/her own protection. The Pay-As-You-Go system locks and traps each citizen in their own track, secluding them from fellow citizens. It takes the social out of protection. It is no longer a system of universal coverage, in which each plays a part, but rather a concretization of the fragmentation of society. Now, each person is alone in the hunt for his/her protection. 

Solidarity through Communication: Challenges from Society 

Even though the new laws, schemes and ensuing bureaucracy are burdensome, people work hard to keep their rights. An interview with a self-employed widow, Mona, confirmed this.[23] Mona works as a cook in several households. She is over sixty, and secures her earning through her work and the pensions she receives, as her father was a government employee. She also has access to a subsidies card, which gives her several discounts on bread, flour, pasta and sugar. When asked about the subsidies, she said she and her sister follow regularly any developments and any announcements from the ministries. They compare their purchases month by month and see what they are entitled to, what applies to them and if not, then why. Her sister, an employee, asks her co-workers the same questions, and they spend much time reporting to one another and sharing their stories. Mona notes that the government’s communication of the changes has also increased for the better since Mubarak’s era.

She shared her account of an experience she had when she went to receive her pension last July. She went expecting a ten percent increase, which she had heard about. To her surprise, they had deducted twenty-five percent of the pension. She did not leave until she had asked and inquired carefully. She requested a revision. As it turns out, the sum initially received had been miscalculated. She said she went from office to office until everything was explained to her, which added another couple of hours to her errand.  Mona has told this story to many of the people she knows, “not out of pity,” she said, “but because it’s important that others hear and are aware of the situation I have been put through and always check what they receive.” “When I was telling this story to a friend, another replied with a similar experience of hers,” she noted: “that’s how we know.” “It’s not the first time I am put in this situation,” Mona said: “with my disabilities pension, I prepared all the paper work and spent many months trying to understand why I wasn’t eligible. I still have the papers in case the laws change.” These may be tacit protestations but they represent communication at its best. There is a social contract built, strengthened and sustained with every shared story and report.  

Mona, like many others, has found her way into the public sphere, from where she can criticize and discuss with others the policies of the government. As a result of coordinated knowledge sharing, she can request revisions and submit claims for readjustment. Relying on communication and creating networks thus allows her to survive. Her communicative reason, arguing and discussing the adjustments, goes much further. It is also a communicative action through which she maintains and strengthens her relationships with others, contesting the individualism of the system. It is finally a communicative power, which allows her and others to confront administrative power. This concept of Habermasian communication is at the heart of Mona’s network of solidarity.

Conclusion: What Is and What Ought to Be

One cannot discuss state society relations without thinking of Rousseau’s Social Contract. In this work, he begins by picturing how society ought to come about, what brings it into being and what upholds it: la volonté générale or the general will.

Since men cannot create new forces, but merely combine and control those which already exist, the only way in which they can preserve themselves is by uniting their separate powers in a combination strong enough to overcome any resistance, uniting them so that their powers are directed by a single motive and act in concert.[24]

If we imagine Rousseau’s social contract and its implications for the social insurance system, we would need a system that is decided by the people, where protection does not depend on the wealth or age of the person, and where all of society helps all of society. The protection of all by all.

Applied to the Egyptian case, this general will is, to some extent, concretized in the Nasserite public funding scheme, and is neglected in the help-yourself-protection in place since the Sadat era. Even though the Nasserite state was authoritarian and paternalistic, its social insurance schemes were reflective of a society that knew how to share. The social protection systems that came afterwards did not always uphold the societal element. Their instabilities and the decreasing coverage rates are a testament to this. In the 1960s, there was no contract, but there was a social element, in the 1980s, there was a contract but no social cohesion.

Now, where does that leave Umm Mohammed? Ideally, her husband should have been covered. She, the new widow, should receive a survivor pension. But, like many, her late husband feared he would never see his benefits back. Like many, she may not even be aware of her rights. Now, Umm Mohammed relies on another type of protection, one that is societal without involving the state. She receives help from her neighbors and participates in the gam‘iyya cooperative, which could be more true to Rousseau’s social contract than the current social insurance system.

[25] Jean Jacques Rousseau, The Social Contract, Penguins, 59-60.