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Hefty charges keep patients away from govt, pvt hospitals

Already struggling to make ends meet as the cost of living escalates by the day, people now are just short of crying out aloud that the health sector in the country has become a lucrative commercial business.

The government’s decision to change the healthcare fee structure in 2003 came as a shock to many expatriates who had earlier been enjoying ‘free’ hospital visits, even to the extent of inviting their relatives from their home countries to enjoy quality and affordable medical care in the UAE.

On the other hand, private health businesses bloomed with the sudden surge of a huge expatriate population preferring private to government medical facilities since the costs incurred were similar.

During an earlier interview with Khaleej Times, Shaikh Majid Al Qassimi, managing director of Al Zahra Hospital, while referring to the government’s implementation of the new fee structure in 2003, said “since the government increased the fees for its healthcare sector, the private healthcare businesses hiked their costs by about 150 per cent”.

“Healthcare in the UAE has definitely become a ‘lucrative’ business since healthcare costs have increased dramatically over the years,” said P Raman, a resident of Sharjah.

“There is no relief in sight because the government and private hospitals both charge the same amount. There is no option but to depend on what is being offered. Either this, or spend on travelling back home which is unsatisfactory and expensive in some cases as well,” he opined.

“I have seen people get disappointed and never return for their follow-up visits since the government increased the healthcare fee. Only visits to the emergency section are free and that too if the patient has a valid health card,” said a doctor working for a local government, on the condition of anonymity.

“If people think that their illness could take a back seat for a while, they never turn up again at the hospital. People are afraid of a huge medical bill that they may have to cough up. They do not have that kind of money anymore,” she added.

“We can only sympathise with them because, we too, despite being health professionals are not entitled to discounts,” she added.

According to a 2006 World Health Statistics report, in 2003, the out-of-pocket private expenditure on health was a staggering 70.40 per cent.

Out-of-pocket spending is the direct outlay of households including gratuities and payments in-kind made to health practitioners and suppliers of pharmaceuticals, therapeutic appliances, and other goods and services whose primary intent is to contribute to the restoration or to the enhancement of the health status of individuals or population groups.

It also includes household payments to public services, non-profit institutions or non-governmental organisations, excludes payments made by enterprises which deliver medical and paramedical benefits, mandated by law or not, to their employees.

The government’s total expenditure on health as percentage of gross domestic product, 2003 stood at 3.3 per cent.

The private sector, on the other hand, have a free hand to charge as much as they wish.

“We have to trust them because they are the experts. If they say that a person needs a particular treatment to survive, then we are ready to pay up whatever they demand even if it means taking loans,” said Fazeel Khan, who recently paid Dh50,000 as Intensive Care Unit charges for a loved one in a private hospital.

“I have no health insurance, all I have done is taken a loan and used up my credit cards. Saving the life was more important. I have no idea how I will clear my loans,” he added.

As part of the government’s plan, in 2003, the Department of Health and Medical Services (Dohms) introduced a new fee list for gynaecological and maternity services.

“Even then it was a shock to the expat community as all the government announcements were very sudden. Till that time, I have never given preference to a government hospital because I have to pay for myself, therefore, it does not make any difference if I pay to a private hospital or a government one. Both charge the same amount more or less,” says Shanti Sudhir, a housewife.

Pregnant women have to pay Dh2,500 as registration fee, other than the payment schedule for the delivery itself. The fees for the Health Care Programme for Natural Delivery is Dh2,000 for a sharing room and Dh3,000 for a private room. The charges for a caesarian section are much higher. Private hospitals are charging the same amounts, and in return are offering better ‘packages.’

A conclusion of the WHO report published in the East Mediterranean Health Journal, which was based on the views of arguments and points in favour of the current health care system, states: “Why is it that the perception of people remains that the health care system is not as good as it should be, that the quality of care in its facilities leaves much to be desired and that it needs a major overhaul? Why is it that patients prefer to be treated abroad, despite the difficulties associated with treatment abroad? Why is it that patients seek the private health care sector of the UAE in increasing numbers?”

The report has been an attempt to provide the reader with an overview of the main health care indicators in the UAE. The somewhat unusual demographic situation has been described, the mortality indicators have been reviewed and the utilization indicators of hospitals, health centres, health facilities and programmes analysed.

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