Introduction and Summary
The Dubai Health Authority is anchored on two major ideals. First, all residents of the city ought to have access to healthcare. Secondly, healthcare must be of high quality that can fulfil the needs of the targeted population. It is a requirement for all residents and nationals of Dubai to have mandatory healthcare coverage. In Abu Dhabi, the mandatory health insurance law was enacted in the year 2005. The requirement is extended to companies in Abu Dhabi and migrant workers in the company.
There are several relevant outcomes deduced from these laws in the United Arab Emirates. First, all residents of the two cities of the country are mandated to have insurance covers. Secondly, companies are obligated by the laws in the country to cover all workers with insurance covers. Thirdly, recognition of non-residents as part of targets of insurance covers has helped put all under favourable access to health care.
These elements of healthcare policies in the two cities point to a country focussed on enhancing quality healthcare in the country. However, there are still a number of shortcomings in the two healthcare insurance cover policies. As a way of providing effective mandatory health insurance policies in Abu Dhabi and Dubai, the administrations should focus on the overall cost, localities of coverage by the insurance policies on the insured and the network of services provided in the insurance covers.
Background
Abu Dhabi and Dubai now have mandatory insurance policies enacted in 2005 and 2014, respectively. These laws target nationals and residents of the two cities. The laws also obligate companies in the two cities to cover their employees, whether they are originally from the country or immigrants. According to Jabbour & Yamout (2012), effective healthcare insurance covers are supposed to maximally relieve health burdens of the insured. Insurance covers covering only parts of required healthcare requirements fail to capture the aspirations of the insured, and essentially, is a challenge to the county in attracting foreign investment. There are several shortcomings in Abu Dhabi and Dubai mandatory healthcare insurance policies.
Chapter two, Article 3 of the Law Number (23) of 2005 in the Emirate of Abu Dhabi exempts a number of categories from the health insurance cover. For example, a non-UAE wife who is married to a national in the country is exempted from this healthcare plan.
Also, there is no particular health provision in the law for tourists coming to the country. Chapter 2, Article 4 of the law state that the nationals are not mandatorily required to subscribe to the cities healthcare plan. Such kind of exemptions and non-requirements are general challenges that may harbour or have harboured effective implementation of an effective healthcare scheme. Jabbour & Yamout (2012) is of the view that an effective healthcare insurance scheme is one that is mandatory to all nationals of a country. To non-residents, it is supposed to be voluntary.
The shortcomings witnessed in the two laws governing healthcare access in the United Arab Emirates, and specifically in Abu Dhabi and Dubai compromise the quality of healthcare. Important in good access to healthcare and in instituting insurance healthcare schemes is the leverage of costs, widening the network of access and increasing the scope of access to healthcare. The following discussion looks at major options for an effective insurance scheme.
Option one: Leverage Cost of Insurance Healthcare Schemes
Cost is always a great concern for ineffective access to healthcare. In Dubai, contributions by individuals range between AED 500 to AED 700. While this is recognized as a minimal contribution, the coverage is very minimal. Members in the scheme are therefore expected to contribute more if they are to access wider services of the healthcare plan. Annually, the limit of the claims is AED 150,000.
This includes even coinsurance that is paid by each and every other member. It is possible that the cost may be more than this amount, especially when there are emergencies. This, therefore, does not fully remedy the health problems members may be suffering from. In Abu Dhabi, the annual limit is AED 250,000. While this is significantly high as compared to the limit in Dubai, it still does not offer a comprehensive medical cover as emergencies may push costs higher than the amount quoted. In this, therefore, it is important to leverage contributions. For example, increasing the amount contributed by members as a way of increasing the annual limit will significantly offer members the most needed health relief.
Option two: Increase Network of Services in the Insurance Healthcare Schemes
Based on the contribution, the number of services listed in the two schemes is limited. Essentially, emergencies are not covered by the schemes, while a number of drugs are not accessible through the schemes. For example, for child delivery, AED 500 will be deducted in Abu Dhabi, while in Dubai; there is a 10% co-insurance with AED 7,000 as the limit for normal delivery and AED 10,000 for C-section operation.
For maternity checkups, a member in Abu Dhabi will be required to pay AED 20 for consultation, while in Dubai; there is a limit of 8 visits in the 10% coinsurance plan. This kind of limitation in service provision in the two schemes significantly limits the quality of access to healthcare in the two cities. An effective health care plan is one with total coverage. The solution to this is to put the optimal cost in contribution.
Option Three: Increase the Localities of Access to the Insurance Healthcare Schemes
The two insurance healthcare schemes are listed in the two cities. In Dubai and Abu Dhabi, the schemes are limited to the two cities, with only the emergency treatment being spread to all emirates. This means that a member suffering from an ailment covered by the schemes apart from emergencies can only access the services in the two cities. This clearly highly limits access to quality healthcare. For example, if a member goes to work in another city, he or she would be required to go back to the city of membership to the insurance schemes so as to get the needed medication. This is not a limit to effective healthcare.
The administrations of the two cities need to give reviews to the insurance healthcare schemes to cover localities other than the two cities, but only for members of the schemes. It is also important to increase the network of access to people affiliated to members. For example, non-UAE wives married to nationals cannot access healthcare. This is discrimination as the non-nationals become part of the country on marriage. As a remedy, therefore, it is critical to the increasing locality of access in healthcare.
Recommendations
There are several negative outcomes noticeable in Abu Dhabi and Dubai Mandatory Insurance Healthcare schemes of 2005 and 2014, respectively. The shortcomings are related to the limitation of services, limitation of regions to access Medicare and limitation on annual claims. These shortcomings hamper good delivery of healthcare services in the United Arabs Emirates, and specifically, Abu Dhabi and Dubai.
It is therefore recommended that; one, the cost of a membership to the healthcare schemes be leveraged to increase the limit to annual claims. To, it is important to increase the network of services provided by the two insurance healthcare schemes. Three, it is important to increase localities and regions that the members can access healthcare services covered in the two schemes.
Reference
Jabbour, S. & Yamout, R. (2012). Public Health in the Arab World. Cambridge: Cambridge University Press.