Egypt’s online invoicing will marginalise pro bono medical treatment

Professionals in Egypt are angry. Lawyers have demonstrated in front of their union headquarters, and the doctors’ union has met to reject the law introduced by the regime for all invoices to be issued online. The change affects companies, institutions and organisations, as well as individuals.

This is being done to help the state to collect taxes, and nobody objects to this. Nearly 80 per cent of the state budget in Egypt comes from taxes, the payment of which is a requirement of citizenship. So doctors employed by state hospitals, for example, have taxes deducted at source and get paid net of statutory deductions such as income tax. Doctors with private patients may use an online invoicing system already for some of them. Likewise for the larger companies, businesses and suchlike. Although tax evasion does happen occasionally, it is rare among professionals like lawyers, doctors, pharmacists and engineers; most follow the system and pay their taxes.

The online invoicing requirement, though, came as a shock to the doctors who work in the private sector, not only because of the equipment and training needed to implement a billing system, but also because many apply the doctors’ oath meticulously and treat patients with humanity, mercy and sincerity, seeking a higher reward than monetary returns. In many cases, this means providing pro bono treatment for poor patients. The “doctor of the poor” is a widespread phenomenon in Egypt but looks set to be marginalised by this new legal requirement.

READ: Egypt lawyers reject electronic invoicing system

These doctors now face the possibility of being charged with tax evasion simply because they will not issue an online invoice out of kindness and humanity towards their poor patients, as they do not take any payment from them. This will not be accepted by tax collectors, who generally assume the worst and assume that everyone pays for everything. It will put an added burden on poor people who already cannot afford to pay for adequate healthcare in a society where the government health sector is unable to cope. Forget the media hype about the new health insurance project, which has been delayed for five years and covers only three per cent of Egypt’s population so far and is only applied in two small governorates.

The new law is like a sword on the necks of all doctors, who are caught between the hammer of unjust legislation and the anvil of society’s needs, which the doctors’ cannot ignore because they took an oath before God and they don’t want to break it. The Egyptian regime set a deadline of 15 December for registration on the tax authority website; harsh penalties await those who do not register on time.

What this issue highlights apart from anything else is that legislation should not be imposed without first having a comprehensive discussion between the government and vital stakeholders in society so that expert opinion can be taken into account.

This article first appeared in Arabi21 on 5 December 2022

The views expressed in this article belong to the author and do not necessarily reflect the editorial policy of Middle East Monitor.