Qatar’s insurers call for larger role in new health system

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Health services in Qatar are in the midst of transition, with a new national health insurance scheme progressively being implemented. While government officials maintain the system will improve medical outcomes and efficiency, the private sector has objected to their limited responsibilities under the new regime.

As part of a plan unveiled earlier this year and codified through legislation gazetted in June, the newly established National Health Insurance Company (NHIC) is charged with the implementation and management of the universal health insurance programme, which is to be enacted in five stages through to 2015.

A multi-year roll out

The first phase has already been implemented, with coverage provided to Qatari women for gynaecology, obstetrics, maternity and related health conditions. This will be followed in the first quarter of next year with full health services for all nationals at select facilities, then by expanded access to private, as well as public health centres in the third quarter. The programme will then be extended to include white collar foreign workers and visitors in early 2015, with the balance of expatriates covered by the end of that year.

The state will continue to carry much of the cost for health care, at least for nationals, with the law committing the government to paying premiums for Qataris, foreign workers employed by the state and their families. For expatriates working in the private sector, employers will be responsible for premiums. Tourists will be required to pay for their own coverage, with fees to be levied along with the issuing of a visa.

Dr Faleh Mohammed Hussain Ali, the assistant secretary-general of the Supreme Council of Health (SCH), told OBG the new system will improve the efficiency and efficacy of the health care, as well as open up access to private sector providers for Qataris.

At the same time, however, the new programme will alter the role of the private sector in the insurance industry. While policy writers will still be able to provide insurance for those health services not covered by the NHIC, this will be a limited part of the much broader market.

According to Ahmed Yousef, a senior advisor to Qatar Insurance Company’s group president and CEO Khalifa Al Subaey, excluding private insurers from the market would not only reduce growth in the insurance sector but also reduce the standard of medical services provided.

“Restricting national companies from the health insurance business will bring down the quality of services, hamper growth of insurance companies and deteriorate health care services. People will be left with limited options,” Yousef told a press conference on November 4.

While accepting that the NHIC should provide basic services to Qataris, Yousef suggested the sector would like to see a division of labour, in the interests of maintaining a vibrant and competitive market.

“The best thing on the part of the government is just to leave the competition going on,” he said. “The NHIC can take care of citizens’ healthcare and leave expatriates and visitors for private companies.”

If insurers retained access to foreign workers, their families and overseas visitors under any compulsory scheme, this would give them the lion’s share of the market, at least in terms of numbers. Of Qatar’s population of some 2m, around 300,000 are nationals.

In other GCC markets where health insurance is mandatory – including Saudi Arabia and Abu Dhabi – the government supplies insurance to nationals only, leaving the market to provide coverage for the remainder of the population.

Opportunities under new system

To date, there seems little to suggest that the government will amend its plans. However, some insurers are more optimistic about opportunities under the new system.

“In Saudi Arabia the ultimate driver of insurance and higher penetration rates was mandatory health and motor cover. So we welcome the new scheme, although we are still not sure how exactly the mechanism will work,” Bassam Hussein, CEO of Doha Insurance Company, told OBG. “In the long term, the primary advantage will be in raising the awareness of insurance.”

Other details have yet to be finalised, including the matter of premiums, an issue of significance to employers, though officials have said rates will be set at accepted standards and the scheme is not intended to be revenue positive.

While the insurance sector may suffer in the short-term, its overall prospects are robust, having posted compound annual growth of 17.9% over the past six years. Qatar’s expanding economy, underpinned by energy and infrastructure developments, should still provide significant opportunities.

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