A senior government official has refuted claims that Abu Dhabi’s health insurance plans for low-income workers jeopardize well being by skimping on preventive care.
Daman, the Authority’s national insurance company, has come under fire from physicians concerned that its budget scheme will impact on patient care. Under the plan’s cost restrictions, low-income patients are not covered for preventive screening or care.
Jay Cooper, acting CEO at Sheikh Khalifa Medical City, told
Medical Times
: “It’s a really strict plan. It’s very restrictive on preauthorisation and high cost tests and there are multiple exclusions. Alternative funding is needed to provide a safety-net.”
Responding to criticism of the scheme, however, Dr Oliver Harrison, head of public health for the emirate, assured physicians that shortfalls in the plan would be addressed through government funding. “There are two ways that it will be dealt with,” he said. “First by direct government subsidy and funding, and the second is actually through the health insurance.
“The principle that we’re working to is that nobody is disadvantaged because of their health care in terms of preventive medicine, so any gaps that there are in principle from health insurance will be met through other sources of funding.
“Money will be found from one of a variety of sources to make sure that happens.”
Dr Harrison also revealed that the Health Authority oversees exclusions with “absolutely authority”. He said: “The health authority for Abu Dhabi, as the regulator, sets forth for the health company what is included in their premiums. So if we say vaccinations are all included, they are all included.”
A decision will be taken in the next few months on whether to extend the remit of Daman’s low-cost plan, he added. “It is under review. So over the course of the next few months, a decision will be made on what will be sitting in the basic package and the enhanced package.”
However, the Authority has no current plans to include preventive screening and care, Dr Harrison admitted.
Physicians across Saudi Arabia and the UAE have expressed their frustration at what they see as the loss of preventive care in the transition to private healthcare. Few regional insurers include annual screening, or physicals in their plans.
Dr Jack Borders, medical affairs manager at Tawam Hospital, Al Ain, believes preventive care should be a standard element of all care plans. “Preventive healthcare consultation can be coded for and billed just as any other procedural code,” he said.
Dr Hussam AbuSeido, a primary care consultant at Saudi’s SAAD Specialist Hospital, said “A comprehensive primary care infrastructure should be our priorities at this time of changing medical care systems. There should be preventive care education in schools and general educational programmes.
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