Dubai debuts 'healthcare for all'

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The new scheme will have primary care at its core, said Al Murooshid.

Every worker in Dubai will have equal access to medical services, under a radical and long-awaited revamp of the emirate’s healthcare system announced last month.

Companies will be required to pay a fee per employee to the government, to cover the costs of basic healthcare for expatriate workers and their dependents. The scheme will ensure access to primary healthcare, non-emergency inpatient care and some prescription drugs, while stopping short of writing a "blank cheque" for all health services, said Qadhi Saeed al Murooshid, director general of the Dubai Health Authority (DHA), who unveiled the plan.

Employers will pay a flat fee, expected to be between AED500 and 800 (US$136 and US$217) per worker and dependent, to be transferred to a central clearing house that will manage the Health Benefits Contribution fund.

Insurance companies will be expected to issue policies that are tailored to incorporate this basic funding system.

"Our objective for the funding system is to provide a high quality, affordable and accessible health service that will provide a good basic standard of healthcare in Dubai, which is similar to that provided by leading developed countries," said al Murooshid. "It will be compulsory for everyone and will be largely employer or sponsor funded."

The scheme hopes to recast primary care as the cornerstone of the health system. Expatriate residents will be required to sign up to a primary healthcare clinic by the end of the year.

In a similar approach to that seen in the UK, residents will be expected to first visit their clinic and be referred on for secondary care only on the advice of their primary physician. Patients will be charged a small co-pay for each visit, thought to be around AED25.

Primary healthcare clinics will receive fixed payments for each registered patient, and each facility - whether public or private - will be responsible for its own budget, planning and service delivery. The approach is intended to encourage competition between government and private clinics, as each will be wrangling for patients. The DHA also plans to publish medical outcome data for each facility.

"For patients, this will result in greater choice, more accountability, better service and, in the long term, higher quality healthcare," claimed al Murooshid.

Notably, the plan has made no immediate provision for preventive care. Simon Hodges, a panel member of the DHA's management team, said the agency was considering creating a central fund for preventive care that healthcare facilities could bid for. The DHA would award funding to the most worthy schemes.

Murooshid said fuller details of the insurance scheme would be made public later in the year. The plan is not expected to be fully implemented until 2015.

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