January 10th, 2018
Emirates of Abu Dhabi Health care system| Structure of AD healthcare: Services, eligibility, financing and challenges
The UAE healthcare system exemplifies a predominant government driven healthcare system with a developing private sector. The government through the ministry of health envisions a system that is accessible to all the residents – both nationals and expatriates – (‘Health services’ n.d) by providing much of the support to the institutions. The involvement of private sector players in aspect such as funding and service provision has been encouraged however been encouraged in modern times (HAAD 2009b). The delivery of healthcare services in the UAE is organized into six distinct federal institutions with nine regional healthcare districts (WHO 2007). The regions, in whose domain the provision of primary healthcare services is rested, have some autonomy and authority with the hospitals and healthcare centers situated in these regions offering comprehensive services to all residents (WHO 2007). Such decentralization has been advanced to result into a better system of healthcare in the UAE (WHO 2007). Other activities performed through the UAE’s healthcare system include preventative approaches such as, immunization programs for infants, polio eradication programs, and combating malaria – the latter being via the screening of persons entering the country since most of the cases are derived from abroad (‘Health services’ n.d; HAAD 2009c). Further, services such as training, offering pharmaceutical services and providing the requisite healthcare infrastructure such as hospitals, specialized treatment centers and herbal and alternative medicine research centers are other core activities incorporated in the UAE health care system (‘Health services’ n.d).
A major concern for many healthcare systems around the world is the structuring of health financing. In earlier years it had been identified that the federal government through the ministry of health (MOH) provided much of the funding to the UAE’s healthcare sector (1.26 billion dirhams in 1995) of which a chunk (71%) financed the salaries and benefits of MOH employees; 25% on general services, pharmaceuticals and outsourced treatment for 190 referrals; and equipment consuming the remainder (p. 155). This situation still persists with the government noted to finance up to 81 percent of the healthcare services but having taken steps together with the emirates of Abu Dhabi to enhance the privatization of healthcare (‘Health services’ n.d). A problem with a mainly government funded health care system would be the competition with other sectors for resource allocation which could make some of the programs instituted to stall in the event of inadequate funding . These flaws have necessitated the establishment of a self-financing mandatory insurance-oriented system using AD as a pilot project with other such projects being planned to be introduced into other parts of UAE such as Dubai (Clyde & Co 2010).
The establishment of a mandatory health insurance as been the policy through which HAAD wishes to ensure AD’s healthcare system becomes self-sustaining. Various regulations that identify the prerequisites that all players in AD healthcare sector (providers, third party administrators and insurers) must adhere to before offering services to expatriates have been put in place (Clyde & Co 2010). Compliance is ensured through placing responsibility on employers and sponsors of resident expatriates to make sure their employees or those sponsored – their spouses and at most 3 children 18 years – acquires a valid health insurance (Clyde & Co 2010). The authority has identified progress in that health insurance contracts have increased among the residents in 2008 with 33 authorized insurers competing for members (HAAD 2009b, p4). This, as the strategy advances, would help the hospitals run as autonomous institutions that are not overly dependent on the government funds for survival. The challenges to the policy mainly comprise restrictions on insurance entity’s residence and flexibility in the type of services offered (Clyde & Co 2010). Another problem with insurance funded medical systems relates to the possible pushing of the healthcare costs beyond the reach of some of the inhabitants when insurers are not regulated to avoid charging too high premiums (Chua 2006). Such would then make the ultimate vision of ensuring every resident’s access to quality healthcare with the freedom to choose the preferred provider a mirage. Go to part 4 here.