Private Healthcare in Morocco: Balancing Public and Private

In 2025, health systems around the world face a twofold requirement:

1. Expand access to care.
2. Ensure economic viability.

In Morocco, this challenge has particular resonance in a context of structural reform, marked by the generalization of Compulsory Health Insurance (AMO), the rise of the private sector and the desire to guarantee equitable, sustainable access to care that meets the population's needs. The health sector in Morocco is undergoing a major transformation, driven by strong private-sector expansion and stimulated by new investment funds.

An Accelerated Transformation of the Health Landscape

To address insufficient hospitalization capacity and promote better access to care, Morocco has introduced several measures, including encouraging investment in the private sector. Private clinics in particular have seen notable growth in recent years, supported by the arrival of investment funds and the opening of private clinic capital to financial actors through Law 131-13, adopted in 2015.

Private clinics now account for more than one third of hospital beds and nearly 90% of primary care facilities.

The Akdital Example: A Model of Rapid Expansion

The Akdital group, the sector leader, embodies this dynamic. Listed on the stock exchange in 2022 after a record fundraising round (4.5 billion dirhams), it saw its share price triple. Since its creation in 2017, Akdital has grown from one clinic to 22, with the ambition of reaching 45 facilities by the end of 2025 and 62 facilities by 2027. This growth is based in particular on a real-estate outsourcing model inspired by the hotel industry and large-scale retail.

Today, through Akdital, regions that previously lacked hospital facilities, such as Guelmim, Salé and Dakhla, are being equipped with clinics at the cutting edge of technology.

A Financial and Structural Balance That Remains Fragile

Despite this rise of the private sector, the overall financing of the health system remains imbalanced. Around 60% of health expenditure is borne by households, despite public spending representing 6% of national GDP. The stated ambition is to reduce this share to 30% by 2035.

The private sector's hospitalization capacity now exceeds 15,000 beds, or more than one third of national capacity. Since 1990, the number of private clinics has quadrupled, while the public sector, over the same period, has seen its capacity stagnate or even decline: between 2017 and 2022, the number of public beds fell by 1%, compared with 50% growth in the private sector.

Paradoxical Effects of the Reform: The Private Sector as AMO's Major Beneficiary

Launched to strengthen equitable access to care, the generalization of Compulsory Health Insurance (AMO) appears to have had the immediate effect of channeling a large share of spending toward the private sector. In 2022, 80% of AMO financial flows went to private facilities, where third-party payment became the main expenditure item.

This shift is explained in part by the structural difficulties of the public sector: persistent medical deserts, staff shortages, aging infrastructure and governance failures, particularly within university hospitals. In response, the government is planning a reform built around three axes (see our article for more information):

• Upgrading infrastructure.
• Improving governance.
• Strengthening human resources.

Healthcare Privatization: A Dynamic That Needs Regulation

A growing number of experts are warning about the potential effects of a widening imbalance between the public and private sectors in Morocco's health system. Professor Jaafar Heikel, a physician and economist, is among those warning against a form of gradual deregulation, in which private-sector growth would come at the expense of an already weakened public sector.

The concerns relate in particular to:

• A concentration of resources and public effort toward the private sector.
• Opaque practices, such as exclusivity agreements between clinics and practitioners.
• Growing dependence on operators driven by economic logic that does not always coincide with the principles of equity and the public interest.

Despite these risks, many experts acknowledge that private-sector development is unavoidable if access to care is to improve, provided it is made into a complementary and regulated lever.

Toward Fair Pricing and Regulated Partnerships

According to Prof. Heikel, this dynamic is not an ideological choice, but a pragmatic reality faced by many countries. The central challenge then becomes financing: how can a system be built that combines efficiency, equity and economic sustainability?

One of the priority paths, according to Heikel, is the adoption of pricing adapted to patients' economic realities. This requires negotiations between the public sector and private operators to establish fair prices that guarantee both quality of care and citizens' financial protection. The goal is to build a high-performing health system based on equity, where the patient pays as little as possible without compromising service quality. The partnership between the public and private sectors must therefore be accompanied by strong regulatory rules and rigorous evaluation mechanisms.

For Jaafar Heikel, this transition toward a more mixed health system must be managed with restraint. The private sector should not be seen as a substitute for public action, but as a complementary actor. Intelligent cooperation between the two sectors, based on solidarity, innovation and balanced governance, would make it possible to build a more accessible, resilient and sustainable health system capable of facing the growing challenges of the 21st century.

What Does This Look Like Internationally?

On the other side of the Atlantic, the debate over public health is also intensifying, and privatization is increasingly present in health system organization models.

Faced with limits on public resources, many countries, whatever their health models, rely on partnerships with private actors, whether for-profit or nonprofit. Germany, Spain and Canada are concrete examples, illustrating a global trend toward the structured integration of the private sector into care management. These examples show that a well-regulated partnership between the public and private sectors can improve care provision while preserving the fundamental principles of universality and social justice.

Conclusion:

The ongoing upgrade of Morocco's health system, marked by the rise of the private sector and the generalization of Compulsory Health Insurance, opens up new prospects for improving access to care. However, it raises fundamental questions about the balances to preserve between profitability and the public interest, and between managerial innovation and social justice. While the private sector appears to be an essential lever for filling public-sector gaps, it cannot be its substitute. The success of this transition depends on the public authorities' ability to define a firm regulatory framework, strengthen investment in the public sector and establish transparent, responsible governance.

How, then, can Morocco build a genuinely equitable health system, where economic efficiency and the right to health no longer stand in opposition but reinforce each other?