Lebanon’s healthcare system, once considered one of the country’s strongest sectors, is facing a growing financial and operational crisis as hospitals struggle with unpaid dues, rising costs, inflation, and declining support from insurers and state institutions.
A healthcare system on life support
Lebanon’s healthcare sector is in danger, and silence is no longer an option. The warnings coming from hospitals echo the alarms raised by economic experts before the financial collapse. The question now is whether a sector that survived some of the country’s darkest and most difficult moments is approaching a similar breakdown, or whether authorities will listen to the concerns of more than 40,000 healthcare workers, doctors, nurses, employees and staff, and finally make hospitals a priority on the government agenda, supporting and restoring a sector that once stood as a pillar of trust, safety and economic strength for Lebanese citizens.
Despite the criticism it receives from time to time, and the voices blaming hospitals for the rising cost of healthcare, Lebanon’s hospital sector remains among the strongest in the world, both in the quality of medical services it provides, the expertise and readiness of its doctors, and its ability to withstand conditions far beyond normal circumstances. It is a jewel that deserves protection, says Pierre Yared, president of the Syndicate of Private Hospitals, who recently issued a warning calling on all sides to take responsibility for protecting the sector. He cautioned that several private hospitals have already reduced the number of beds, medical services and employees.
Major challenges have accumulated on Lebanon’s healthcare sector since 2019: the financial collapse, the COVID-19 pandemic, the Beirut port explosion, the pager attack, two consecutive wars and widespread local and global inflation. Together, these crises have placed hospitals under enormous financial and operational pressure. The government remains overwhelmed by its own crises, negotiations and efforts to manage the consequences of wars, while the Ministry of Public Health has not paid any of its outstanding dues to hospitals since the beginning of 2026, after payments had improved during 2024 and 2025. Meanwhile, the tariffs it pays have long remained far below the actual cost of care, according to Yared.
Insurance companies, meanwhile, delay payments to hospitals by up to a year or a year and a half in some cases, says Rima Bakhazi, director of BMG Hospital. Their contracts require payment within no more than 60 days, yet most companies fail to respect this deadline. Their tariffs also remain below pre-crisis levels, reaching only 70–80% of 2019 rates.
The National Social Security Fund faces its own financial difficulties yet continues trying to remain the link between citizens and hospitals by paying its obligations. However, its tariffs have not returned to 2019 levels and still cover only around 40% of the real cost of hospitalization.
This comes without forgetting the damage suffered by Beirut hospitals after the port explosion, forcing them to rebuild, renovate and treat the wounded without receiving state compensation. Southern hospitals have also faced destruction, attacks and displacement, forcing some to shut down.
A heavy price for years of crisis
Yared acknowledges that without insured patients, hospitals would not have been able to survive, as insurance tariffs remain better than those paid by the Ministry of Public Health. Hospitals are now negotiating with insurance companies to increase those rates. However, while hospitals in Beirut rely more heavily on insured patients, hospitals outside the capital depend mainly on the Ministry of Health, the army and security forces. Any delay in payments leaves them unable to continue operating.
Yared lists a series of pressures facing hospitals, including delayed payments, rising prices, inflation, higher fuel costs and increasing prices of medical supplies, which have made operational expenses exceed revenues.
He gives the example of Geitawi Hospital, which he manages, saying it requires ten tonnes of diesel daily, equivalent to around $12,000 per day. The American University Medical Center, together with surrounding facilities, consumes around 50 tonnes per day. With electricity costs among the highest worldwide, reaching nearly 35 cents per kilowatt-hour, the burden of securing energy alone becomes enormous.
Yared notes that French hospitals, for example, avoided operating air conditioning systems during the peak of heat waves, while Lebanese hospitals must keep their air conditioning running almost continuously, further increasing costs.
Added to this is the security situation in the south, which has displaced residents and forced hospitals to evacuate, pushing many people into severe economic hardship and making them unable to afford medical care, especially since hospitals in Beirut are more expensive than those in southern Lebanon.
Yared explains that the Social Security Fund currently covers only 40% of hospitalization costs, forcing hospitals to request patients pay the remaining 60%. The fund has warned some hospitals and cancelled contracts with others because the additional amounts requested from patients were considered excessive.
“We are forced to request these additional payments,” Yared says, “so that we can continue operating, as long as they remain reasonable."
The solution is for the Social Security Fund to increase its tariffs so that the gap becomes smaller. Hospitals do not charge these additional amounts to the army and security forces.
He also points out that the banking crisis has prevented hospitals from obtaining financial facilities needed to purchase supplies and equipment, worsening their financial situation and threatening their ability to continue.
Bakhazi believes the problem involves multiple actors and began in 2019 before worsening after the Beirut port explosion. The Ministry of Health did not reimburse hospitals for treating victims of the blast. As for pager attack victims, the state paid according to old prices that no longer reflect current inflation, leaving private hospitals forced to act like public hospitals without receiving appropriate compensation, despite lacking the financial ability to do so.
For Bakhazi, the biggest obstacle remains insurance companies, which delay payments even though insured patients represent 60–70% of all patients. When companies eventually pay what they owe, inflation and rising costs have already reduced the value of the money, leaving hospitals unable to cover replacement costs, meaning replenishing medical supplies, medicines and equipment.
Between an exhausted Social Security Fund and insurance companies controlling the healthcare market, hospitals find themselves “caught between two pressures.” They are not receiving tariffs that allow them to survive, while salaries for doctors, nurses and employees have returned closer to previous levels and operational costs, especially energy costs, have increased dramatically.
While insurance companies act collectively and face limited oversight, hospitals are prevented from negotiating and coordinating, are subject to monitoring and receive warnings.
Added to this is the disorder of medical centers and clinics, which do not face the same strict oversight as hospitals and increasingly compete with them.
The Lebanese Order of Physicians has imposed appropriate tariffs on insurance companies, and doctors today receive around 105% of their pre-crisis compensation, whether from patients or insurers. Private hospitals, however, remain unable to impose fair tariffs on insurance companies. The solution begins with stronger oversight of insurers and forcing them to meet their responsibilities, especially since insured patients represent the largest share of hospital users.
Who pays the higher price?
Lebanon’s hospitals are divided between major university hospitals, medium-sized hospitals and smaller facilities. The country has 130 private hospitals and 40 public hospitals, with a total capacity of around 10,000 beds.
While smaller and medium-sized hospitals generally have lower operational costs and greater ability to control expenses, large hospitals, despite their enormous costs, are often more capable of surviving because they receive support and assistance from multiple sources, according to both Yared and Bakhazi.
International organizations, donors, boards and universities affiliated with hospitals all contribute financial support and grants. The American University Medical Center, for example, received $150 million from its American board, while Hôtel-Dieu received donations from the Order of Malta. Equipment upgrades and new technology are often funded through donations, as happened with Geitawi Hospital, which received a surgical robot as a donation.
However, whether large or small, Lebanese hospitals need government support and must become a national priority, as happened during the financial crisis when then-Army Commander Joseph Aoun prioritized healthcare for soldiers and their families, helping preserve the army’s cohesion, according to Yared.
Today, all ministries must treat healthcare as a priority to revive a sector whose role extends beyond health. It represents an economic driver worth millions of dollars.
The problem is not limited to hospitals’ relationship with the Ministry of Health, Social Security Fund, insurers or funding bodies. It involves several ministries trapped in the same cycle.
The Health Minister sends invoices to the Finance Ministry, which delays approval due to the lack of available funds. The Labour Ministry oversees the Social Security Fund and can push for tariff increases, but the fund cannot improve payments without improving revenue collection. The Economy Ministry must pressure and monitor insurance companies to ensure timely payments. The Energy Ministry must work to reduce energy costs for hospitals.
While it is true that state revenues have declined, expenses have increased and repeated wars have contributed to the collapse of several sectors, Yared insists that the solution ultimately lies with the government as a whole and requires making healthcare a national priority.
We have been exhausted and have reached the edge of the cliff. Our warning today is meant to prevent it from becoming too late.
