Hospitals are calling for tighter regulation of health insurance companies, accusing firms of underselling policies and leaving hospitals to pick up the tab.
In a sharpening dispute between physicians and insurers, doctors contend that health insurance premiums are so low they are jeopardising the economic viability of hospitals.
Dr Mazen Soliman Fakeeh, director general of Dr Soliman Fakeeh private hospital, Jeddah, said his hospital is being squeezed by insurers trying to recoup costs on cut-price premiums.
“The brunt of this competition has fallen on us, the healthcare providers, because the insurance companies cannot afford to pay our bills and we cannot afford to lower our prices without lowering our standards.”
The debate was sparked off after Saudi’s Ministry of Health announced mandatory health insurance. The government agency established a minimum level of coverage for all plans but did not establish a minimum level of pricing.
As a result, the rise in insurers in the market has gone arm-in-arm with a drop in premium costs as firms fight to attract patients.
Fakeeh warns that unless rates are increased, care standards will deteriorate as hospitals cut corners to meet costs.
“There has to be a fair and equitable minimum or it will destroy quality institutions and facilitate the spread of cheap facilities, cheap doctors and cheap care and this is not the direction that we want our country to go in.”
Tensions between providers and insurance companies may prove a barrier to the effective implementation of national health insurance. Some hospitals are already opting for cash-only policies, to avoid lengthy wranglings with third-party firms.”
“A spokesperson for Saad Specialist Hospital, Al-Khobar, told Medical Times; “We have standards and we cannot lower them to meet lower premiums.”
In the United Arab Emirates, physicians have also reported unethical selling by insurance firms. Dr Andre Wessels, medical director of Welcare Hospital, Dubai, contends that patients sold cut-price health plans are unaware of how little coverage they will receive.
“There are a lot of policies out there that should never have been sold,” he said, adding that local firms were the worst offenders.
Dr Khaldoun Sabbagh, deputy CEO of the International Modern Hospital, Dubai said: “Patients sign a contract presuming it covers everything – they don’t have the knowledge of medical terms to understand.”
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