Posted on Apr 06, 2011 by Sergio Ulloa
Kuwait's national healthcare system is set to undergo substantial reform and transformation in the next 3 to 4 years under the new Kuwait Health Assurance Company (KHAC), affecting both nationals and expatriates who look for health coverage options in the country. Kuwait is looking to evolve its health services policy from a welfare state into a 'healthcare business.'
KHAC was established in 2010 by Ministerial Resolution 586 to develop a comprehensive public-private enterprise tasked with improving the healthcare sector in Kuwait and to guarantee high quality medical services for residents. The expansion of the Kuwaiti health system would be financed through the implementation of a new private medical insurance system issued through the company brand. KHAC plans on eventually enacting Law 1/1999, which instructs Kuwait to begin incorporating an integrated universal medical security system that would cover expatriates and ultimately extend services for all residents. KHAC also wants to provide substantial support in the development of the Kuwaiti private healthcare industry and to promote their individual medical services through proactive participation within the health development company.
Speaking at a press conference held for potential investors, Mohammad Al-Munifi, KHAC Chairman, explained the strategy of the new organization: "We have a vision for synergy and cooperation between the private and government sectors. By letting the private sector manage such a project, we expect an efficient health care system in Kuwait and a better experience for patients."
The Kuwait Health Assurance Company has a capital sum of KD318 million (US$ 1.15 billion). The company is operating as a partnership between the Kuwait Investment Authority (KIA), the Ministry of Health and the private healthcare sector, with 26 percent of the ownership share to be auctioned off to a strategic partner. The KIA is largely in charge for the administration and auctioning of new shares in KHAC.
The initial proponent of KHAC's healthcare development strategy calls for the construction of three major hospitals in Ahmadi, Jahra and Farwaniya and 15 new polyclinics throughout the country within the next 3 to 4 years. These facilities will be built and operated by private companies. The Kuwaiti government is set to grant renewable 20 year leases with KHAC for the proposed locations, and has given the company a three-year grace period to obtain all necessary licenses and successfully finish the construction and equipment of all new medical buildings. Kuwaiti Health Minister, Dr Hilal Al-Sayer claimed that the project represents the biggest health development initiative in the Middle East and would provide employment opportunities for over 1400 doctors and 4000 nurses and technicians.
The development of these new facilities, providing a projected 1,600 new hospital beds in Kuwait, will help ameliorate the structural pressure the state health provider network is currently facing. Substantial population growth, especially from the growing expatriate community, coupled with increased life expectancy rates and the escalating global costs of medical treatment have placed substantial burden on the health system's resources. Demographic forecasts will exacerbate this trend. The current population of Kuwait is 3.5 million inhabitants and is growing substantially at 6.8 percent a year. Life expectancy at birth in Kuwait has increased substantially by 20 years within the last half century, from 59.4 years in 1960 through to 78 years on average in 2008.
Kuwaiti citizens are provided with free healthcare services from the publicly run hospitals and clinics. Foreign nationals in Kuwait must obtain health insurance from the government run scheme, as per residency requirements, or through a local healthcare system provider. Expatriates are required to pay additional out-of-pocket payments towards medical costs in the Kuwait public medical facilities. The compulsory state insurance scheme does not cover private treatment or repatriation costs. The law defines an appropriate alternative private healthcare company as one providing over 900 beds across Kuwait's governorates and as Ahmad Nossouli of the Advisory Group explains: "there are no such healthcare providing companies½we have private hospitals and clinics, but they don't meet the minimum requirements." The average cost of healthcare services per person in Kuwait has increased substantially in the last decade, doubling to KD 112 (US$ 404) from KD 56 (US$ 202) between the years 2002 and 2009. All these factors push people towards the state hospital system and have resulted in medical personnel and equipment shortages, overcrowding, longer waiting times for treatment and a growing dissatisfaction with the public health care sector.
KHAC Chairman Al-Munifi confirmed that the Kuwaiti system could not continue on this trajectory: "We don't expect the government to continue spending money on healthcare for non-nationals, even for nationals - there are many indicators that suggest the government won't be giving free healthcare and education."
The new private health insurance scheme, provided through KHAC, would provide access to the newly constructed healthcare facilities as well as other public-private practices set up around Kuwait. The price for the annual health assurance policy for the first ten years has been set at KD130 (US$468.8) per person and KD120 (US$432.7) during the tenth year. KHAC reserves the right to increase charges in the event inflation in Kuwait exceeds six percent in the coming decade.
The establishment of KHAC is intended to diversify healthcare provision and will deliver more opportunities for the private healthcare industry in Kuwait. Al-Munifi asserted: "The private sector today provides about 10 percent of healthcare, which is a small market share. This percentage should be increased in the future through government support and providing health opportunities." If another healthcare provider, meeting the minimum 900 bed capacity requirement, comes to market alongside KHAC, individuals will have the opportunity to choose between them. The Kuwaiti government is looking forward to foreign input on the marketplace, as Health Minister Dr Hilal Al-Sayer explains: "With this project we want a new health insurance system in Kuwait," adding, "This will be an opportunity for the private sector to participate and be involved."
Once the new KHAC insurance scheme is implemented, the Ministry of Health will stop issuing their health insurance certificates to foreign nationals. "In order to stamp their visas, expatriates in Kuwait must obtain insurance from the KHAC," Chairman Al-Munifi continued "We believe that the maximum fee of KD 130 is very reasonable, considering the quality of healthcare the KHAC will provide." The introduction of the KHAC insurance scheme will further necessitate changes in sponsorship laws for Kuwait, to ensure employment does not capriciously deduct new healthcare fees from their foreign staff.
The KHAC insurance system is not exclusively a healthcare option for expatriates as Chairman Al-Munifi notes: "Many [Kuwaiti] nationals prefer to go to private clinics instead of public clinics because of the poor quality of service at public clinics. We want to give affordable premium healthcare services to all residents of Kuwait whether nationals or non-nationals alike."
The Kuwait Health Assurance Company is part of Kuwait's National Development Plan (NDP). Initialized in 2010, the plan will organize several hundred development projects and initiatives in housing, transport, social services and healthcare, with total infrastructure spending expected to reach US$108 billion. The NDP is designed to promote and diversify further economic growth in Kuwait, improve the state's general services and ensure the state remains an attractive global business center. The private sector is expected to account for almost 50 percent of the net spending set out in the project and would participate through joint stock companies and partnerships between the Kuwaiti state and multinational businesses. The increase in private and state funding resources will most likely improve the local marketplace. While the increase in oil prices has enabled Kuwait's economy to successfully recover from the 2008-09 global economic crisis, further success and long-term growth could be determined by the successful execution of the NDP.