Saudi- Call for organizing health insurance sector

(MENAFN- Arab News) There has been a long delay in the implementation of health insurance according to several academics here who urged Minister of Health Ahmad Al-Khateeb to consider the matter on priorities.

Quoting economic studies they said health insurance will involve a saving of SR38 billion which will also enable the citizens to get high level of services from the private health sector.

They said the current health insurance program covers treatment cost for diseases afflicting individuals according to an official insurance document that offers advanced health care for an annual fee.

Talking to local media they said the delay in implementing health insurance is due to a number of reasons the most important one being the absence of basic structure for health services.

Undersecretary of Health Dr. Othaman Al-Rabeia said insurance for the private sector employees based on cooperative health insurance for Saudis and expatriates is in force since 2005.

There is an optional health insurance but it has not been applied to all citizens but a study has been conducted and recommendations were sent to the Saudi Health Council and the Health Insurance Council to formulate a comprehensive health insurance project.

Professor Hasan Saleh Jamal a member of the teaching faculty at King Abdulaziz University stressed the importance of applying the health insurance system on all citizens.

Insurance expert and health administrator Rida bin Mohammad Khalil said reasons behind the late implementation of health insurance are due to lack of conviction of its implementation or fear of implementation results.

He said the system does not prevent insurance companies from targeting the citizens directly in order to provide health insurance services for them and their families. These insurance contracts are linked to a bundle of benefits that connects the insured and insurance companies; the bundle of health benefits is supposed to be in return for a fee agreed upon between the two parties.

There are 20 million citizens in need of health insurance with 20 percent of the insured from the private sector he said adding that more steps need to be taken such as expansion in health insurance services to include all services needed by the insured and in all medical specializations.

There is also a need to develop the health insurance information system in government health facilities and automate it to deal with health insurance requirements communicate with health insurance train medical staff in health insurance to work in health facilities and raise the maximum levels of insurance coverage for all catastrophic diseases and accidents.

An emergency fund to cover cases that exceed the maximum coverage levels need to be set up in addition to spreading insurance culture and raise the level of awareness among the citizens and devising a new and flexible pricing system to define prices of medical services that is based on diagnostic groups to facilitate the pricing procedures.

An independent entity for taking responsibility for managing health insurance affairs in the Kingdom has been suggested for introducing the participation system in paying for the insured by a limited sum so as not to abuse health services.

Dean of the Business College at King Abdulaziz University and an expert in health insurance affairs Dr. Abdulilah Saati called for the setting up of a national commission for medical insurance under the supervision of the Saudi Arabian Monetary Authority (SAMA).

The situation he said confirms the presence of a crisis in getting health service even in the private sector though the Saudi market is a promising and profitable market.

Head of Public Health Department in Imam Mohammad bin Saud Islamic University Dr. Mahmoud Abdulraham Mahmoud said health insurance is one of the solutions to the vexed issue of providing medical services for the citizens.