This article appeared originally in Gulf News: link to original article
I showed up at a hospital appointment one day and it was cancelled. I wasn’t informed. I asked if the doctor was in the clinic by any chance and I was told that he’s conducting a surgery.
Morale of the story? Doctors get more cash from surgeries, paid by insurance companies, than from normal follow-up appointments.
Why did that happen? Insurance policy has changed recently, sending all affected to the same hospitals, creating long queues at registration, negatively affecting provided service, and the very serious cases being deferred for treatment, which could be life threatening.
Health economics is possibly one of the most misunderstood and underused fields in the region. Think about it.
What governs the relationship between insurance companies and health service providers? Should a government invest in its own hospitals, or facilitate the process for different health service providers to acquire government hospitals or construct and manage their own?
Should a government send people for treatment abroad, or should it provide health insurance plans with worldwide coverage? And all this will need to be drilled down to cost of this versus cost of that.
Benefits should also be an integral part of the calculation, but the point is to get the best health service out of it, and so as long as we are not comparing a five-star service to a two-star one, then no issues.
So how should a decision be made when it comes to health economics? For the UAE, this should be looked at from a federal perspective and from an emirate perspective.
Federally, “Thiqa” is the insurance that everyone can avail, where coverage is split between one for the entire UAE and one that is in Abu Dhabi only. Please note here that I am not discussing the percentages paid by patients, if any. Thiqa is also the main insurance provided in Abu Dhabi.
“Saada” is the one provided for Dubai nationals, with a UAE-wide coverage. It’s basically Dubai’s thiqa for Dubai nationals.
Now here is an interesting fact. If you are a Dubai national, you can have Saada to cover you in all of the UAE and Thiqa to provide you with full coverage in Abu Dhabi, including most importantly Cleveland.
Could there be a duplication here? Possibly. And holding two cards means that you go for the one that minimises your co-pay amount.
According to Dubai Health Authority (DHA), treatment cost per patient was an average of Dh1.7 million, with treatments in the US and the UK being the most expensive (2013). And this prompted two actions: first, the Dubai Medical Tourism Programme, and second, Saada medical insurance.
The first is to divert patients to Dubai Healthcare City and expand medical tourism, while the second provides Dubai nationals with a variety of treatment options in the UAE itself. So, a medical insurance is the better, cost-efficient option as long as the cumulative premiums paid per individual over years of coverage is lower than the sum of current and future costs of treatment abroad.
The latter estimation requires thorough analysis of individuals’ medical history as well as their families’ history in relation to the costliest non-communicable diseases in the UAE. Using that same logic and the same formula, what if the premium paid on a medical insurance that covers you worldwide is lower than the average Dh1.7 million paid per patient in 2013.
As I was shopping lately for a medical insurance, I had a few options that offered worldwide coverage (including and excluding the US) at a cost ranging between Dh25,000-Dh35,000.
A simple calculation here would be that Dh1.7 million equals 56 years of premium per individual (number will be lower as premiums tend to go higher with age, health complications, etc)
The last question that I want to leave you with: will total costs paid for treatment abroad suffice for worldwide-coverage medical insurance for all UAE nationals?