Gulf Daily News - 30/4/2006
GOVERNMENT officials are proposing a five-stage plan to make private health insurance compulsory for all non-Bahrainis by 2013 to reduce the strain on government health services. Health Minister Dr Nada Haffadh said the ministry was already working on the preliminary stages to introduce compulsory health insurance for some expats by 2008. It wants to first introduce compulsory insurance for expats working at large companies with over 500 employees and gradually expand it to cover those at smaller firms.
There are currently 400,000 non-Bahrainis entitled to unlimited health services at government hospitals, health centres and Salmaniya Medical Complex (SMC) Accident and Emergency Department.
Foreign residents account for about 39 per cent of the total population and 72pc of the total workforce.
In 2004, the government budget for free healthcare was BD88.4 million - approximately 7.4pc of total government expenditure that year.
The average health expenditure per capita stands at BD202.6.
"The Bahrain government recognises that action must be taken now to address the increased demand on health resources," said Dr Haffadh.
"The Ministry of Health aims to provide enhanced and higher quality healthcare for Bahrain to meet the healthcare challenges ahead through more private sector partnerships, patient choice and planned mandatory insurance for expatriates in the short term.
"As a first step, the ministry's objective is to implement a National Health Insurance (NHI) scheme for expatriates working in Bahrain.
"In this scheme the healthcare benefits for expatriates will be provided through private health insurance."
Dr Haffadh was speaking at a one-day symposium on Health Insurance for Non-Bahrainis held at the Diplomat Radisson SAS Hotel yesterday.
Around 500 healthcare professionals, private companies, employers, sponsors of non-Bahrainis and decision makers attended the event, held under the patronage of Dr Haffadh.
The Health Minister said the NHI scheme would be brought in gradually to ensure legislators, private health insurers, employers, expats and other stakeholders were ready.
The Health Ministry's recommendations are based on advice from actuarial consultant Muhanna and Company, which carried out a study called The Implementation of a Compulsory Health Insurance Scheme for Expatriates in the Kingdom of Bahrain last year.
The study recommends a private insurance scheme to be implemented gradually starting with a preliminary stage, followed by five phases - one to be introduced each year.
"In each phase (phase one to five), an additional category of non-Bahrainis will be covered by private insurance," said Muhanna and Company actuarial consultant Ibrahim Muhanna.
"At the last year of implementation, each non-Bahraini resident should be covered by private insurance."
During the preliminary stage there would be no private insurance involvement, but an increase in the fee and levy systems currently in place.
Under the current healthcare system, employers with more than 50 employees pay a levy of BD30 per expat to the Health Ministry in return for them being granted access to government health services for a nominal fee.
Expats pay a fee of BD1 per visit and BD3 in case of an emergency.
However, in the first phase of the scheme health insurance cover would be required for expats working for companies with more than 500 employees.
Companies with more than five employees would also have to start paying BD30 per expat to the Health Ministry.
In phase two, health insurance coverage would be expanded to expats working for employers with more than 50 employees.
In phase three, health insurance coverage would be expanded to expats working for employers with more than 10 employees.
In phase four, health insurance coverage would be expanded to all expats, except domestic helpers.
In phase five, health insurance coverage would be expanded to all expats including domestic helpers.
According to the report, the overall increase in costs for the employer will not be significant.
It states that firms that rely heavily on expatriates would find labour costs would represent only a small portion of their total expenditure.
Mr Muhanna said the implementation of private healthcare for expats would mean new roles and responsibilities for various bodies.
The Cabinet, for example, would have to adopt a Health Insurance Law, as well as a Health Insurance Commission, which would be responsible to develop the necessary regulations to implement and enforce the law.
He added the Labour Ministry would have to update the Labour Law for the private sector to reflect the new provisions of the health insurance scheme.
Meanwhile, the Interior Ministry would have to verify that workers entering Bahrain had the necessary health insurance coverage.
"The Health Ministry would issue medical cards to cover expatriates under the levy system, giving them access to public facilities," explained Mr Muhanna.
"In case insurance companies refuse to cover an employer, the Health Ministry would have to allow those employers to stay covered under the levy system.
"Hence the ministry would be considered as the insurer of last resort.
"However, it would have to examine the employers' solutions to get private insurance or to agree on some special finance arrangements under the levy system."