A package of health care reforms set to be introduced in Bahrain by early 2019 is designed to improve patient choice, while also enabling the private sector to play a greater role in provision. Although the introduction of a National Health Insurance Scheme is a central plank of the agenda, reforms considered as part of the National Health Plan 2016-25 are more extensive and will also give greater autonomy to individual hospitals and clinics as well as create a clearer distinction between the regulatory and service provision roles played by government departments and agencies.
The impact of the planned changes was summed up by Sheikh Mohammed bin Abdullah Al Khalifa, the chairman of Supreme Council of Health (SCH) in a foreword to the most recent annual report by the National Health Regulatory Authority (NHRA). “As we move forward to implement the national health insurance system, the presence of a strong and well-regulated health sector will contribute favourably to the success of this major milestone all the while creating an encouraging environment for health care investments.” In August 2017 the SCH chairman highlighted the role of the NHRA in the introduction of the national insurance programme, known as Sehati, or “my health”, through its remit of inspecting, licensing and accrediting all hospitals, health institutions and professionals in both the public and private sectors. Under the new system the NHRA will work in cooperation with the Hekma Centre, which would operate under the SCH and be responsible for monitoring, regulating and directing the kingdom’s health system.
PACE OF REFORM: The World Bank has been acting as a consultant to help the government of Bahrain to replicate best practice in implementing the health care reforms. The SCH has worked with the World Bank, conducting surveys and field visits to other countries to examine the best ways to integrate public and private health provision and insurance schemes. The SCH has also been holding meetings with key stakeholders across the spectrum of health care provision and consumption to explain the impact it expects the plans to have on patients.
IMPACT ON PATIENTS: There were concerns among some citizens that they would be expected to pay for a service that had previously been free; however, officials were quick to allay their fears by pointing out that the government would continue to fund the basic package offered to citizens for treatments at public hospitals. It will do this by paying premiums on their behalf into a central fund called Shifa. Bahraini citizens will also be able to make individual contributions if they wish to co-pay to use additional treatments or services, such as VIP suites that are offered by private sector providers.
Private insurance companies will take over health care coverage for expatriate workers and residents. “The new health insurance scheme, which will make it mandatory for all citizens and residents to have medical coverage, is expected to significantly increase the role of the private sector,” Kasim Ardati, CEO of Bahrain Specialist Hospital, told OBG. “Although the details of the final scheme are not yet available, we expect that both insured locals and foreigners will have the choice of getting medical service from public or private sector hospitals. We are still waiting for more clarification from the SCH.”
In 2015 the Ministry of Health introduced a new ruling requiring private employers to buy mandatory health insurance for all of their employees while applying for work visas to the Labour Market Regulatory Authority. Companies with fewer than 50 staff members were required to pay BD72 ($191) per expatriate staff member and BD22 ($58) for each Bahraini on the pay roll. Private companies employing more than 50 staff were given the option to launch their own health insurance schemes.
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