Financing of the Healthcare System - Assignment Example

Answers

• The healthcare financing systems of GCC countries are unique because of their source of healthcare funding and the population. They do not rely on people or external help to finance healthcare. The other distinctive feature of GCC healthcare financing systems is their demographic characteristics. They have a very high number of expatriates, which explains healthcare financing systems have to determine how to provide healthcare to these expatriates without burden.
• The demographic characteristic affecting healthcare financing in GCC countries is the high expatriate population relative to the total population. GCC countries are compelled to use different strategies keep expatriate healthcare expenditure in check. It has a significant impact on the healthcare financing systems adopted by GCC countries.
• (A) GCC countries are classified as high income countries by the World Bank based on the level of income. The high income from its natural resources is comparable to that of developed nations. Also, they share the urbanization rates of developed nations as evidenced by the number of skyscrapers being developed in GCC countries.

(B) GCC countries have very low literacy rates, which a characteristic observed in most developing nations. It explains the classification of GCC countries as high income developing nations. The other features of developing nations observed in GCC countries include a poor health profile, and massive challenges all the processes that facilitate the delivery of quality healthcare.

• The study utilized a study framework developed by Joseph Kutzin to analyze healthcare financing in GCC countries. The framework consists of methods used to raise revenue, strategies used to accumulate healthcare revenues on behalf of the population, mechanisms for purchasing healthcare, service provision, and the out-of-pocket payment methods. The framework analyzes the benefits package that comes with a healthcare system, which includes an insurance scheme or any other benefits. The comprehensive nature of the framework adopted for the study ensures that every aspect of healthcare financing is analyzed to identify the strengths and challenges that come with a particular healthcare financing system.
• The study utilized data from the WHO healthcare expenditure database. The choice to go with the data from one source was good because it makes the comparison worthwhile. Data on healthcare financing might vary because of the factors that affected its collection and compilation. The use of data from one source eliminates the need to go into finer details because the data was compiled and utilized by the same source. I believe it is a wise approach and helps in giving the comparison credibility.
• There are several reasons to explain the availability of limited data on healthcare financing in GCC countries. The obvious ones include the fact that it is difficult to get actual data from the institutions in this country, and there is little research that has been done on healthcare financing in GCC countries. Most studies focus on developed and developing nations and do not give much focus to the GCC countries.
• Literature search was conducted electronically and by hand to ensure that all relevant literature is included in the study. There is the possibility that some of the research papers might have been written in Arabic. A search was conducted in Arabic search just in case some researchers might have been left out. The use of keywords was critical to the success of the whole process because it ensures that all the related papers come up in the search. Government papers and research papers from different databases to widen the search. The keyword selection demonstrated a deep understanding of the subject of the study and the kind of literature needed for review.

• (A) GCC countries are all concerned about the healthcare financing given the fact that it has a significant impact on the overall country income. The common objective for all GCC countries is to minimize government healthcare expenditure by reducing healthcare expenses associated with expatriates.

(B) Qatar has the highest expatriate population, which stands at 78.3% of the total population.

(C) UAE has utilized a number of strategies to ensure that the government does not meet a big chunk of expatriate healthcare expense. The Ministry of Health (MOH) issued a directive that requires expatriates to pay annual fees if they are using government healthcare services. Also, they are expected to pay additional fees to cover for prescription drugs, and any other diagnostic tests. Recently, the state of Abu Dhabi made a law that requires all employers to provide healthcare insurance for their employees and their families under three schemes: for unskilled and lower paid, for Nationals, and the one for highly skilled expatriates. The method used by Abu Dhabi is yet to have a full impact. All these strategies have made it possible for GCC countries to keep healthcare public expenditure in check.

(D) The impact of the strategy utilized by Abu Dhabi has been positive because it ensures that all expatriates have healthcare insurance cover. However, the long term impact is still not clear even though there is the belief that it will be beneficial to all the stakeholders. It is a much better way of controlling healthcare expenditure without denying expatriates access to important healthcare services.

• Kuwait and Bahrain prefer a cost sharing service where expatriates meet a part of the cost of healthcare. It helps control public expenditure. Oman requires all expatriates to have health insurance cover from their employers.
• The revenues obtained from oil and taxes form the main source of funding for healthcare in GCC countries. The taxes from alcohol, tobacco and other substances considered sin are not adequate to cover healthcare expenditure, which explains the substantial dedication of revenue from oil to fund healthcare services.
• (A) The total health expenditure for GCC countries is about 72.5% while that of high income nations stands at 62.2%. Based on these averages, GCC countries tend to spend more on healthcare than these high income nations.

(B) According to the explanation provided by the authors, the total health expenditure is the total revenue dedicated to healthcare financing while per capita is the amount of money used to provide healthcare for each individual. The per capital expenditure is higher in high income countries compared to GCC countries. I think the explanation is applicable in the UAE because it refers to the average money spent on each person. Concerns can be raised about the strategies used that ensure expatriates contribute a significant amount and the value they spend on healthcare might be higher than the per capital expenditure for GCC countries.

• CEBHI is Compulsory Employment-based Health Insurance. The scheme requires all employers to provide healthcare insurance cover for all employees. It is a system that is meant to give the public expenditure on healthcare low, without compromising the ability of one to access quality healthcare services. The implementation of CEBHI has reduce out of pocket payments for healthcare services and increased private healthcare insurance expenditure in the private sector.
• The regulation of insurance market in KSA was delayed by the resistance from a section of Islamic Scholars who believed commercial insurance is not permissible in Islam. KSA constitution is based on Islam which made it difficult to implement the scheme. The country had to rely on council voting that ended in a stalemate leaving the chairman with the option to pass the law. The Royal Cabinet approved the scheme and it became law.
• CEBHI is a risk pooling insurance scheme means that premiums are set based on the size of the company and the risks facing an employee. This means different employees will have different premiums. It might be a big hurdle for some employees who face major risks but the income is low. The premium set for small employer is crucial to the success of the CEBHI scheme.
• GCC countries utilizes strategies that emphasize expatriates must share cost with the government when it comes to healthcare services. The per capita expenditure is based on the assumption that everyone is treated the same, which is not the case. It seems expatriates have a higher per capita expenditure than the nationals. The healthcare indicators are not a reflection of the country’s per capital expenditure.
• Access to healthcare is a major concern because most healthcare institutions are fragmented. Also, the number of insurance companies willing to provide healthcare insurance are not so many. The fragment nature of providers makes it difficult to access quality healthcare. There is a need to increase the distribution of healthcare institutions in most of the GCC countries.
• The GCC countries covered in the article have three distinct characteristics. First, they have high income governments because of their natural resources (oil and gas). The revenue generated from selling energy is very high. Second, all these countries have a high percentage of expatriate populations. It is a challenge for governments in GCC countries to fund healthcare services and keep it low. As a result, they have opted to use a number of strategies to make expatriates share the cost of healthcare services. Third, the healthcare system and healthcare financing in all the GCC countries is underdeveloped. The lack of development in the healthcare sector is one of the reasons why GCC countries are still classified as high income developing nations. There is a need for these countries to work on laws and structures that will help improve healthcare deliver and costing.