The generous social health protection systems that Arab governments have built up during the 1960s and 1970s continue to exist but they lack the funds needed to function in the way they did twenty years ago. Even more serious however is the fact that available funds are inefficiently distributed in the existing health care and insurance systems, and socially unjust among the population. This is partly due to (i) a decay of both the supply side and the funding side of the health care sector into multiple co-existing parallel structures that lack coherence and are available only to a certain segment of the population, which thus perpetuates and intensifies the existing stratification of society, and that (ii) the kind of spending in the health care system is given priority that addresses the health care for the urban middle classes, rather than comprehensive primary health care for the poorer and rural population.