Posted on Mar 21, 2012 by Sergio Ulloa
Qatar's ambitious plan to cover the emirate's entire population under a unified national health insurance scheme could be achieved within the next three years, according to a recent interview given by senior Qatari government officials to local media. The system, when finalized, will look to provide state-subsidized medical cover for all Qatari nationals, while local employers will likely be responsible for their expatriate workers' health insurance premiums.
At a press conference on Tuesday, Falah Mohammad Hussain Ali, the Supreme Council of Health's assistant secretary general for policy affairs, announced that the draft law for Qatar's Social Health Insurance (SHI) scheme was now being sent to the Council of Ministers for review. If approved, the SHI scheme will be rolled out gradually over the next few years through various private-public health insurance initiatives until eventually all Qatari residents and visitors to the emirate are covered. The Supreme Council of Health (SHC) forecast that this implementation phase should be finalized by the end of 2014 and should instantly place Qatar's health and social security system among the world's finest. An article from Gulf Times
, a Qatari daily journal, this week further notes that the SHC are also planning to establish a new statutory health insurance body in Qatar to accompany the compulsory medical insurance scheme this year. This new body will oversee the SHI rollout and work closely with Qatar's existing medical insurance companies to ensure there are no duplicate expenses or gaps in healthcare coverage by 2014. After successfully registering and maintaining accreditation with the new government body, health providers would have access to both the public and private patient networks. Exactly how this system will manifest itself is yet to be worked out. Both the healthcare practices in public and private sectors as well as Qatar health insurance companies
' input will be sought out in this exchange.
According to SHI draft law, the first stage of Qatar's national health insurance law will start in November this year. Under this pilot program, 75,000 Qatari women, aged 15 and above, will be added to the SHI scheme's books and enjoy free state-funded obstetrics and gynecology treatment, with more healthcare services to be made available soon thereafter. The pilot program will enable the SCH to micro-manage a small proportion of the potential public healthcare base, allowing them to troubleshoot any problems for the main compulsory health insurance scheme that arise.
The second stage, forecast for July 2013, will then see the state's health insurance coverage network extended to all Qatari nationals for use at primary healthcare facilities and some private sector participants. By October 2013, the third stage outlined, Qatari nationals will be covered for basic medical services at all public healthcare providers in the emirate and by May 2014, the fourth stage, this provider network should be further extended towards private sector companies and most out-patient services in Qatar. The fifth and final stage, earmarked for year-end 2014, will see all Qatar residents, including expatriates and tourists, included within the SHI system. The majority of these scheme participants will then be eligible for a basic benefits package of healthcare services for use at both primary and secondary level medical facilities.
While Qatar have now selected their national insurance system option and laid out their domestic medical coverage aspirations quite clearly, much work remains to be done in setting up the required operating infrastructure and business process model to accomplish their objectives going forward. In accordance with the draft law, the Supreme Council of Health will remain the sole regulator of the new national medical insurance system once it comes into force, but the council itself now expects to establish a separate body to handle the day-to-day responsibilities and administration of the SHI scheme. A third party administrator is also expected to be brought in to catalogue Qatar's healthcare provider network
and handle collecting and paying out medical insurance claims. Furthermore, an international disease and medical condition classification system will be adopted by the SHI in a bid to standardize treatment costs and insurance charges between public and private sector hospitals and clinics in Qatar.
The new healthcare scheme will offer a minimum service package at a pre-determined affordable premium. Standards regarding quality and cost of treatment will be reviewed and made abundantly clear to both providers and patients in the public system. Certain elective procedures, such as cosmetic surgery, are not currently planned to be covered or subsidized through the new scheme. Medical fees in the private sector are also thought to be under review prior to the execution of the national insurance scheme.
While Qatari nationals will simply have their SHI insurance status tagged to their national identification cards, the emirate's sizeable expatriate
workforce will require some structural adjustments to be made to sustain universal coverage going forward. According to the draft law, premium payments made into the SHI system will be linked to the issuance of residence permits and visas in Qatar so as to ensure that everyone in the emirate is properly registered and covered, including even those staying on short-term family and visiting visas. The law further states that "employers and sponsors shall not be issued with residence permits for employees or sponsored persons unless they have subscribed to the SHI and employer or sponsor may not collect any part of the health insurance premiums required to be paid by him from the employees/sponsored persons." People visiting Qatar on a short-term business trip or vacation meanwhile will be required to pay an insurance premium upfront when applying for visas, with the contribution amount determined by their planned length of stay in the emirate. No rules yet clarify whether expatriates currently living in Qatar without an appropriate company sponsor would be eligible for similar benefits.
The SHI scheme has been brought in as part of the Qatar National Vision 2030 and the National Health Strategy
. Although Qatar's healthcare system ranks very well by international standards, the emirate faces considerable problems with chronic lifestyle diseases and medical cost inflation going forward. The introduction of a national health insurance system, similar to moves being made in neighboring Abu Dhabi
, could prove to be the most expedient mechanism to both improve Qatari health and drive down costs.
Supreme Council of Health
Qatar's Supreme Council of Health (SCH) was established by an Emir decree in 2005. The Council replaced both the former National Health Authority and Ministry of Public Health of Qatar and now works to regulate the domestic health market and better represent the interests of medical providers in the emirate.