• Home

Dubai plans law on basic healthcare for all

DUBAI - Dubai is heading towards private health insurance for all residents that will be governed by an insurance law, according to a senior health official.

Once rolled out, the law will mandate basic healthcare to an estimated two million people from all strata of society in Dubai. It is loosely based on existing regional models such as the Daman Health Insurance in Abu Dhabi and the national insurance system in Saudi Arabia.

The regulatory framework of Dubai’s mandatory health insurance law is ready and is currently being reviewed by the Dubai Executive Council. “Timelines for implementation will be announced soon after the law is in place,” said Dr Yousuf Haider, Director of Health Funding Department at the Dubai Health Authority.

“The proposal is in good shape right now and is in the final stages of approval. Once this is done, it will be ready for implementation,” he said without mentioning an expected date for its 
approval.

Implementation in phases

The law stipulates that the sponsor will be responsible for providing insurance cover to those under his sponsorship, be it his family or employees. The law, like all regulatory frameworks, will also address penalties for non-compliance. The regulation replaces an earlier health funding model that was deferred by the Dubai government in 2008 after the global economic climate became unviable for its implementation.

“The Health Funding Department has been working on the law while keeping in mind employers, providers and insurance companies,” said Dr Yousuf. “Though many companies provide insurance cover to their employees, it is done randomly and is not mandatory,” he explained.

An estimated 500,000 people currently have some form of private health insurance in Dubai. “Once the law is fully implemented and over the period of time suggested, everyone in Dubai will have private insurance,” he said.

Companies that will have the lowest impact in terms of the premium on daily operations will come under the law first. “A lot of multinational companies and more established local companies already have private health insurance. So these people will automatically plug into the system,” he explained.

“But then as the rollout process advances, for example, companies with 500 to 1,000 employees from different sectors will also come into the law gradually.”

Dr Yousuf also said that the upcoming insurance model was right for Dubai as per the changing economic climate. “We take into account the cost of doing business. This is not supposed to be a burden on businesses but should add to the economy — not only to the health sector but to the economy across the board.”

Two million to benefit

“From a provider’s point of view, the target population is now two million people. And from the investors’ and private healthcare facilities view point, this is fantastic news because it means that funds in the system are available,” he said.

A recently held Dubai Household Survey revealed that 77 per cent people from the low income bracket in Dubai do not have any health cover. “The law is all about protection and we want to ensure that the weakest members of the society are protected by health insurance,” explained Dr Yousuf.

“So, at the moment, a poor labourer whose salary, for example is Dh1,000 and is sick and does not have health 
insurance, could either lose all of his salary in treatment or save it only if the employer decides to get it reimbursed. So, the aim is that the poor and vulnerable members of the society should not go into financial ruin and take money out of their food or basic requirements.”

All beneficiaries, however, will also have to contribute to access basic healthcare. “There will always be co-payment in any insurance system which ensures that people don’t overuse these services unnecessarily.”

Dr Yousaf said the new model suits the large percentage of expatriate population. “There are large groups that require healthcare at a reasonable cost and decent coverage,” he added.

Before Abu Dhabi came up with its mandatory health insurance system Daman, only 100,000 expatriates out of an estimated population of 1.46 million were medically insured. Since the implementation of the system in January 2007, the number of insured people has increased 10-fold. The basic Daman plan covers examination, diagnostic and treatment services provided that the insured pays Dh20 for every new visit and Dh10 when referred to a 
specialist. 


Enaya under review

The most expensive services under Enaya, the luxury health insurance package that covers 90,000 government employees in Dubai, are being reviewed, said Mona Ali Sultan, Assistant Director, Health Funding Department. The change is expected to be implemented next year.

Officials said that the DHA’s strict check on providers has had positive results with some reporting miscalculated claims themselves. “Some people complained about the pressure the authority was putting on providers,” said Dr Yousuf. “But as a result of the pressure we applied, many clinics have come forward claiming their mistakes; they realised this is serious responsibility.” The authority is in the process of taking legal action against a couple of providers. Dr Yousuf said that misuse of public money was not acceptable.

Malpractice is mostly reported in dental practice, said Dr Mona. “This service is expensive and the billing claims may be higher than in other specialities but we keep checks and balances according to set benchmarks,” she explained.

Another form of malpractice, said Dr Yousuf was pushing patients deliberately into investigations and therapies that were not required. “Many also claim for procedures they haven’t done and this is akin to theft of government money,” he added.

To prevent misuse, the government recently introduced a 20 per cent co-insurance for Enaya users. “Employees got disappointed when co-insurance was introduced but on the other hand they have full access to DHA facilities free of charge,” said Dr Yousuf.

“When there is a co-insurance, people will start to look after that money because they pay a percentage of it,” he said. However, if they do not want to pay, they can utilise the DHA’s Primary Health Care services, he said.

Enaya is the only programme that does not rule out pre-existing conditions such as diabetes or heart disease/chronic conditions. It also covers optical, dental and preventive procedures in DHA while employees can also avail of an annual health screening.

It is a partnership between the Department of Finance, Government of Dubai and Human Resource Department, DHA. “The government HR department is in the final stages of making a law that will spell out penalties and address misuse,” said Dr Yousuf. We also refer many complaints relating to physicians non-compliance and abuse to our colleagues in Health Regulation to look into their professional licensing when necessary, he added.

asmaalizain@khaleejtimes.com