Without universal health coverage, people can be forced to pay for the costs of their healthcare, leading to burdens and poverty. ‘Universal health coverage: Everyone, everywhere’ under the slogan ‘Health for All’ is the theme for World Health Day (WHD) on April 7.
According to the World Health Organisation (WHO), without coverage, lives and welfare of millions of people around the world are negatively affected, particularly in low-income countries.
The UAE already recognises this need and over the past years has implemented varied levels of health cover. While Abu Dhabi has the Al Thiqa plan that covers Emiratis and residents, Dubai rolled out the basic health insurance in 2013 and today it covers over 98 per cent of the Dubai population.
The government is also planning a federal insurance plan that will provide basic cover to all Emiratis and residents in Sharjah and the Northern Emirates.
“The two per cent remaining are those who are still not aware of the insurance cover and others who come on visit visas,” said Dr Ali Lutfi, head of health funding at the Dubai Health Authority (DHA).
He said the authority was always looking at data to improve the insurance plan for blue-collared workers who make up majority of the emirate’s work force.
According to the WHO, almost 100 million people are being pushed into extreme poverty, forced to survive on just $1.90 or less a day, because they have to pay for health services out of their own pockets. In the Eastern Mediterranean region, 40 per cent of the health expenditure comes directly from people’s pockets; people on low incomes and without social protection are the hardest hit.
As many as 55.5 million people across the region face financial hardship as a result of out-of-pocket health expenditure, and as many as 7.7 million are pushed into poverty due to these costs. In some countries of the region, out-of-pocket payments for health services account for over 70 per cent of total national spending on health
“Universal health coverage is a fundamental human right,” said Dr Jaouad Mahjour, acting WHO regional director for the Eastern Mediterranean region.
Universal coverage means all communities receive the healthcare services they need without suffering financial hardship. It enables everyone to access the services that address the most important causes of disease and death, and ensures that those services are of sufficient quality to improve the health of the people who receive them.
“It is also about ensuring access to essential quality care and financial protection,” Dr Mahjour added. “This not only enhances people’s health and their life expectancy, it also protects countries from epidemics, reduces poverty and the risk of hunger, creates jobs, drives economic growth and enhances gender equality.”
Dr Suresh K Menon, specialist internal medicine at Aster Gardens Specialty Clinic, Discovery Gardens, added: “This year’s theme for World Health Day, Universal Health Coverage, means that all individuals and communities receive the health services they need without suffering financial hardship. It includes the full spectrum of essential, quality health services, from health promotion to prevention, treatment, rehabilitation, and palliative care. It is essential as it takes away the stress of healthcare from the people especially in the wake of increasing healthcare costs.”
Talking about how Dubai’s mandatory health insurance has been helping patients, Dr Suresh said: “Mandatory health insurance is in keeping with and definitely a step forward towards achieving Universal Health Coverage. It helps the low-income workers to earn their living without worrying about keeping a bulk of their salaries towards basic health costs.”
About how healthcare organisations and governments can make ‘universal health coverage’ a reality for communities in the near future in UAE, Dr Suresh said that some basic insurances have a problem of reduced coverage and it sometimes becomes difficult to get approvals for certain treatments/procedures. “More involvement by health insurance companies and providers is necessary to collectively work towards providing low cost/affordable care to all,” he added.
To make it easier for residents to get their dependents insured, the Dubai Health Authority (DHA) said that insurance companies in Dubai have introduced the prorated health insurance packages for residents that are linked with the duration of their visas.
The move is particularly beneficial for people with individual packages who forget to renew their insurance. The insurance packages are linked to the visa renewal period and also include the 30-day grace period
Insurance companies will also be introducing flexible payment plans so that people do not have to pay two years up front. To make the rule stricter, sponsors and company owners who violate the Dubai insurance law by not renewing their employees’ and dependents’ insurance every year on time are fined Dh500 per person per month. The fine is deducted automatically via the electronic system at the time of renewing of the visa.
The authority has also recently introduced the Basmah initiative which makes Dubai the first government entity in the world to provide a complete spectrum of care from screening to treatment for three types of cancer under the basic benefit plan.
It covers screening as well as treatment of breast, colorectal and cervical cancer. Prior to this scheme, cancer coverage under the mandatory health insurance scheme as part of the basic benefit plan was limited to Dh150,000. Under the scheme, those detected with any of these cancers will receive coverage from screening until treatment.
Every woman has the right to a peace of mind while preparing to welcome a child into the world.
But buying an insurance policy for maternity health requires more than just a cursory Google search, says Dr Amala Nazareth, obstetrics and gynecology, secretary-general, Emirates Medical Association, member of FIGO (International Federation of Gynecology and Obstetrics).
“The insurance policy is not just a protection in monetary terms, but also provides a cushion for any complications that may incur before, during or after pregnancy. While the ideal maternity health coverage differs from case to case, a few rules of the thumb go a long way in ensuring a smooth and easy ride to parenthood.
For example, when buying insurance for maternity health, couples should look for policies that give them maximum benefit both pre- and post-delivery plus at least 30 days of neonatal care coverage.
“This is particularly important since both antenatal/prenatal and postnatal care is not only expensive, but in several cases, cost can jack up due to unforeseen complications,” she says.
Another important factor is choosing a good facility’s coverage where high risk pregnancy unit and fully functional tertiary level neonatal facility is available.
“When selecting a facility, it is also advisable to remember that many hospitals do not include overhead cost, such as epidural in the insurance coverage, so reading the fine print carefully will keep one ready for all eventualities,” says Dr Amala.
The new insurance policy laws in the UAE state it mandatory for all insurance companies to provide all women UAE residents with maternity coverage with no waiting period.
As per Dubai Health Authority (DHA), every medical plan must include eight prenatal visits with an obstetrics and gynecology, three prenatal scans and basic bloodwork. The insured should not have to co-pay more than 10 per cent of the cost. Similarly, depending on the premium one pays, the insurance should cover at least Dh12,000 for normal vaginal delivery and Dh21,000 for a C-section.
“However, do remember that the cost can go much higher, subject to the choice of hospital.”
Such issues related to maternal health such as nutrition, gynecologic cancers, IVF and pre-term birth among others will be discussed at the upcoming FIGO Medical Congress of Middle East and Africa from April 11 to 13.
Health insurance plans that offer seamless access across borders, especially to your country of nationality or residence, are especially important in the UAE given the large population of globally mobile expatriates. The choice of the geographical coverage of your plan should be based on how often and where you travel.
If you have preferred doctors or clinics within the vicinity of the area you work in or stay at, ensure the network offered by the insurer provides you with that reach and spread. Always request for a network listing prior to reaching a decision on network choices so you know help is readily available nearby, when required.
Nearly as important as network size is how costs are shared. Any healthcare plan’s benefit summary should clearly lay out how much you will have to pay for out-of-pocket services. It’s important to get accustomed to certain health insurance vocabulary terms – deductible, coinsurance, penalties or co-payments.
A good insurance plan should offer customisation capabilities, enough to meet yours and your family’s health needs. The more choices your insurer offers, the easier it is for you to structure a healthcare plan that meets the needs of your family.
A key differentiator in healthcare plans are additional benefits that may be offered by the Insurer. It is a good thing to ask for such value adds.
Make sure your insurance provider has a service team to accommodate your schedule. This means being available 24/7 to answer questions about your plan and its services. Being able to access quality healthcare near you, when an emergency demands this, is priceless in ensuring customer satisfaction and in ensuring better health outcomes
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