Introduction: The sustainability of medical assistance, considered necessary in middle-income countries, requires permanent regulation. In Morocco, the medical assistance scheme (MAS) is confronted with the lack of regulation tools and the difficulty of affixing these tools effectively in the absence of a regulator. In this sense, the shortcomings of the current practice of its regulation should be identified in order to recommend actions and tools to improve its implementation and guarantee its continuity.
Methods: The analysis and the proposed recommendations are based on the review of the available literature, the review of the legal texts framing the basic medical coverage and the analysis of the current practice of regulation of the MAS.
Results: The regulation of the MAS was not treated in the same way as the compulsory health insurance. There is no proper regulator as the case of the compulsory health insurance. In substance, the planned measures remain very insufficient and scattered between several actors and sometimes difficult to apply. Based on a reference framework designed along four axes (resources, expenditures, health care offer and population), the analysis identified fifteen actions and tools to correct deficiencies and support its sustainability.
Conclusion: The proposed recommendations need a durable commitment from all the actors who must trigger as quickly as possible urgent actions to optimize the implementation of the medical assistance scheme and improve its perception in the citizen.