Compulsory health insurance leaves window for treatment abroad

 

By the end of 2015, all residents and expatriates in Qatar will be covered by a national health insurance scheme that will lock out other health insurers but with a window for them to offer treatment abroad.

The standard of health care in this very rich country is good, but can be expensive. Qatar has implemented national healthcare reform intended to alleviate the state of the burden of healthcare costs within the local Qatari population. Only one in ten Qataris has private heath insurance.

By 2015, all individuals living within the country will have a private health insurance policy. In the case of local Qataris this will be funded by the government, however for expatriates employers will be responsible for the provision of appropriate cover, and in the few cases where there is no employer the expatriate themselves will have to buy cover. The fees will be paid annually along with the renewal of residence permit. Cover for locals will be wider than for expatriates.

Qatar’s universal health care coverage program is in five stages and is expected to be fully operational for Qatari citizens and expatriates by the end of 2015.

The pilot phase of the NSHI was launched in July 2013 with Qatari women being provided coverage for maternity, obstetrics, gynaecology and other related issues at Hamad Medical Corporation (HMC) and a selected few private hospitals.

The second stage to be launched in the first quarter of 2014 includes all Qataris, offering them all basic health services at HMC and other private health services providers.

The third stage, scheduled for the third quarter of 2014, will target Qataris and with the coverage expanded to 23 primary health care centres. White collar expatriates and visitors are to be covered by the NSHI’s fourth stage in the first quarter of 2015 and blue collar expatriates in the fifth stage by the end of 2015 at three specialised labourers’ hospitals.

85% of the working population is expatriate; some professionals but mostly low paid domestic and manual workers. Expatriate workers outnumber Qataris by six to one.

New state company National Health Insurance Company (NHIC) runs the country’s new health care insurance system- National Social Health Insurance (NSHI). Qatari insurance company Al Khaleej Takaful has been appointed as the third party administrator for NHIC to handle essential administrative processes.

NHIC will make annual contracts with healthcare providers, based on a unified schedule of fees and charges. NHIC will cover a basic bundle of health services. Other operators could also cover additional and optional services, which give room for partnership with different entities. Though insurance companies will not be able to cover basic health services for the next 10 years, they can cover additional and special services not covered by the main scheme such as cosmetic procedures and treatment abroad. All the public and private health care providers in the country will be included in the NSHI scheme within 10 years; it is up to each entity to attract customers by providing good services at competitive prices.

The local government is authoritarian, and as it owns the national insurance company and many of the hospitals, it now seems that competing insurers will be locked out from providing cover for locals or expatriates, except for supplementary cover above that provided by NHIC.

Local and international insurers had hoped they would be able to compete with the national scheme, but a meeting clarified the position.

Dr Faleh Mohamed Hussein of the Supreme Council of Health explained.”All the public and private health care providers in the country will be included in the NSHI scheme within 10 years. Our target is to provide all the inhabitants of Qatar, even visitors, with the best basic health services, and it is not about profit or loss. Most countries are now opting for NSHI as the only system that services the interests of both nationals and expatriates.  Some GCC countries are now trying to benefit from Qatar’s experience. NSHI will cover a basic bundle of health services. Other operators could also cover additional and optional services, which give room for partnership with different entities. We have started with a limited number of hospitals in the pilot phase. Insurance companies will not be able to cover basic health services for the next 10 years but could still cover additional and special services not covered by the main scheme such as cosmetic procedures and treatments abroad. Local insurers may lose health business when NSHI is fully implemented, but the impact will be very limited as they have other areas they can expand other fields to make up for this.” Private health insurance in the region is still new so it will be unlikely that local health insurers will offer cover for cosmetic surgery or treatment overseas.

The new insurance may put an end to the 1,000 or so Qataris that the government pays to go overseas for treatment.  But it is unlikely to stop the increasing numbers of well-off locals who pay to go to Europe and Asia for medical treatment.

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