Daoud Al-Badriyeh, PhD, Professor, College of Pharmacy, QU Health, Qatar University, Qatar
Despite a gross domestic product per capita that is consistently one of the highest in the world, and just like any other nation, Qatar has its share of population health challenges. Up to 69% of mortalities are because of chronic cardiovascular, cancer, and diabetes diseases, 70% of Qatar’s adults are overweight, 44% of the adults have low levels of physical activity, 88% of children have dental caries, 23% of mortalities are due to injury, and the estimated tobacco use is up to 31% in men. This, no doubt, correlates with health system-level challenges that include increased demand for services and integration across settings, and a difficult-to-maintain workforce to meet demands. The 2030 Qatar national vision aims at “improved health for Qatar’s population, meeting the needs of existing and future generations”; whereby several recent national strategies (2018-2022) have been successfully taking place within a strategic context to develop health care in Qatar. These extend from providing world-class services and preventive care, to enabling a skilled workforce, system integration, efficient policies, quality research, and partnership in health care spending.
Within the context of empowering effective and affordable services, partnership in health care spending has become a particular priority in Qatar. So far, there have been three reimbursement models of health care. One is the governmental reimbursement, which covers the Qatari population, where treating nationals is free of charge, and all residents are treated for minimal co-payments. Second, there is private reimbursement, which is optional through private health insurance or out-of-pocket spending. Third, there is reimbursement through charity, with Qatar Charity, Qatar Cancer Society, and Qatar Red Crescent Society as examples. Here, the population in Qatar is rapidly expanding, potentially beyond the productivity limites of public facilities and free-of-charge care, which has resulted in serious cabacity issues, particularly the long waiting time for appointments.
The very recent law No. 22 for the Year 2021 has constituted the future direction in health care reimbursement. According to this, except for limited exempted resident populations in Qatar, the free treatment at the government health facilities will only be for nationals. Non-nationals can only be treated via private health insurance. This is why, according to the law, it has become mandatory for all residents to have private health insurance. In other words, private insurance will become a compulsory condition of work/visit visas and residency renewal in Qatar, with severe fines for private health facilities that refuse injury and emergency cases. Here, employers are mandated to insure employees and recruits for essential services at private health-providing facilities. I, however, personally believe that this is currently only possible at the level of primary care. At present, the private sector cannot match the tertiary care provided by the public providers as an example. Upon termination, the employer must maintain coverage until the expiry of the policy or the residency permit. Different age-based packages will mostly be available, grievance committees will be established to address complaints, and insurance companies will apply the best systems and procedures to provide effective and quick patient service. A new health finance insurance department of the Ministry of Health was established in 2022 to regulate the system towards being efficient and sustainable.
Overall, the main sought-after goals of the mandatory health insurance scheme include (i) balanced utilization of budgets and health resources available throughout all health care sectors, (ii) enhanced partnership between public and private sectors and the development of the private health care services, and (iii) addressing the issue of long appointments waiting time for nationals, especially the dental and surgical services.