Executive Summary

This paper seeks to analyze the social protection system in Morocco as a whole, with a focus on its main pillar related to the policy of extending compulsory health coverage to vulnerable and disadvantaged groups. Our focus on these groups is intended to highlight their representation and social and cultural attitudes toward the universal health coverage (UHC) programs that aim to guarantee the right to treatment and prevent health risks for more than 22 million additional beneficiaries of compulsory sickness insurance. On 23 March 2021, the king of Morocco issued Royal Dahir No. 1.21.30 to implement Framework Law No. 09.21 on Social Protection, which is based on the provisions of Article 31 of the Moroccan Constitution providing for the right to social protection and health coverage; these goals are also evident in international legislation on the same subject and the 2030 Sustainable Development Goals (specifically the third goal related to health and well-being) to which Morocco is committed.

After analyzing the objectives of the UHC project and its effects on the social reality, the Moroccan medical system, the country’s economic structure, and its productive system, the limitations of these programs emerged, as well as the fact that their results on the target groups are not expected or clearly defined. It will have repercussions on the two-thirds of Morocco’s population who are poor, indigent, and poorly paid after they are transferred from the Medical Assistance System (Régime d’Assistance Médicale, or RAMED) to the compulsory sickness coverage system and subjected to program targeting. As much as this project reveals important ambitions in the field of assistance and reducing socioeconomic disparities in the right to treatment and protection against health risks, it also reveals some of its technical objectives, the ambiguity of its components on the one hand (targeting and taxation), and the extent of the difficulties and structural obstacles that stand in front of it, as well as the inequality and health injustice that it will perpetuate. Thus, the sustainability of health risk protection comes into question.