This article appeared originally in Gulf News: link to original article
My grandmother, whom I dearly cherish, has to be driven for two hours from Ajman every time she has a medical appointment. Being the person in charge of scheduling her appointments, I try my best to have them all in one day so that she wouldn’t need to do it that often.
Her case has, however, exposed a gap in the UAE’s healthcare sector that I did not realise, before then, existed.
Prior to the change in the healthcare sector and its partial privatisation, my grandmother could walk into any public hospital and get treated for anything, subject to the capabilities of the public healthcare provider of course. She still can.
Nonetheless, and as privatisation was introduced, so was health insurance. My grandmother then got a basic plan that grants access to public healthcare providers, but not private ones. While it’s compulsory for employers to provide health insurance for their employees, it is in no way compulsory for similar private health insurance to be provided for my grandmother.
Therefore, and in certain emergency cases, there is no place to take her except to a public healthcare provider, whether that provider is 10 minutes or two hours away.
The same applies to my mother, who after working in a government job for 35 years, retired with a basic health insurance plan limited to public healthcare providers. This means that if she would like to visit a private healthcare provider out of necessity, she can’t unless she uses her pension to pay for it.
Otherwise, she’s faced with the same limitations faced by my grandmother. My mother and grandmother may both defer from visiting private healthcare providers, since they rarely did in the past anyway. Nevertheless, having that option available, for proximity and medical speciality reasons, could be life saving at times.
So, what seems to be the problem here?
When health insurance was introduced, it was not introduced in all emirates. Dubai introduced health insurance for its own citizens, providing them with the option to be treated in both public and private healthcare providers. Dubai also offers free medical services through its public healthcare providers for citizens of other emirates in return for a token fee, payable every four years.
Abu Dhabi, on the other hand, introduced employment-related tiers of health insurance for all Emiratis.
Both health insurances allow treatment in public and private healthcare providers for their citizens. For everyone else, treatment is limited to public healthcare providers, unless employers provide another health insurance that adds private healthcare providers to your network.
This though is limited to the working population, not for my grandmother, who never had a job, and neither is it for my retired mother.
As a result, certain segments of the population seem to have been kept out of the possibilities to be treated by private healthcare providers. This is in no way an advocation for private healthcare providers versus public healthcare providers. But Emiratis must be able to choose between them based on their medical needs and the specialities offered by different healthcare providers.
In other words, basic universal health insurance must be provided for all Emiratis at a federal level that allows for treatment in public and private healthcare providers across all emirates. Chargeable options can also be made available for Emiratis to upgrade their plans should they want to, or to expand their treatment coverage to additional hospitals within the UAE, or to ones outside the UAE.
A leg up for privatisation
Moreover, doing so would allow for further privatisation of the healthcare sector, with the government paying for or subsidising health insurance that allows access to public and private healthcare providers. This also means that the UAE government’s role will need to change from being a market participant and competitor to a regulator, achieved through further privatisation and engagement in Public Private Partnerships (PPPs).
Doing so would enable the government to focus on the above mentioned regulatory gaps and address them, in addition to anticipating future gaps and challenges.
To conclude, the partial move towards privatisation and the introduction of health insurance for all is an important step in the UAE’s healthcare sector. This, however, exposed a gap as retirees and the elderly do not get the same access to private healthcare providers.
This gap needs to be bridged by a basic universal health insurance introduced at a federal level, with the option to pay and upgrade if needed.
The last thought that I want to leave you with: Can the UAE’s healthcare sector be fully privatised without a universal health insurance?