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As health insurance hike looms, questions remain on future of healthcare for expats
By Chidi Emmanuel and Ahmad Jabr
KUWAIT: Foreign residents in Kuwait could be required to pay a KD 130 annual health insurance fee instead of the current KD 50 to renew their visas as early as 2023, according to a recent report by Al-Rai quoting sources at the Health Assurance Hospitals Company (Dhaman). While the increase is far from confirmed, residents realize it’s inevitable, as plans to introduce a new health insurance system for the country’s expatriate community have been in the works for years.
But many foreign workers have voiced concerns over the proposed hike. “It will surely come to pass. A bill like this always starts like a rumor or unconfirmed report, but before you know it, it will become a law. I pray the authorities will not approve this; otherwise, it will hurt a lot of people and families who are already struggling to survive in Kuwait,” Filipino expat Margaret Angelo told Kuwait Times.
The current plan is for Dhaman to provide health services to residents covered under its insurance plan through a network of new hospitals and clinics distributed around Kuwait. The company is currently finalizing preparations to inaugurate the first hospital in its network, which is likely to happen by late 2022. Once the hospital opens and the company’s new integrated system enters operation, the Interior Ministry will be informed to start collecting the new KD 130 fee for every renewed visa, said the sources who spoke on the condition of anonymity, adding that this will likely happen “by the beginning of next year”.
“Actually, anything that goes up in Kuwait doesn’t go down again. Before the insurance fee was KD 10-15, after which they increased it to KD 50 – promising to improve on the quality of services. That never happened, but rather things went from bad to worse. We are still receiving the normal paracetamol and basic medicines. Even if they make the health issuance KD 300, we (expats) still won’t get good medical services. This is quiet unfortunate,” said Dickson, an expat who claimed he spent a lot when his wife was hospitalized, told Kuwait Times.
New healthcare system
The Dhaman hospitals and health insurance program is part of a new healthcare system Kuwait plans to introduce and hopes would improve the quality of healthcare services in a country, where medical facilities have long suffered from overcrowding. Shifting healthcare of its large expatriate population – foreign residents make up nearly 70 percent of Kuwait’s total population of around four million – under Dhaman helps alleviate pressure on the public health sector, which would then focus on providing services to Kuwaiti citizens.
According to Dhaman, most basic treatment costs would be covered under its KD 130 annual insurance for expatriates – unlike the current system where residents pay for medical checkups, lab tests, hospital stay, medications and other services at public hospitals and polyclinics on top of the KD 50 mandatory insurance. While the company promises that the increased cost comes with improved quality services, the almost threefold hike will certainly create financial problems for many in a country, where the average monthly salary for expatriate laborers remains less than KD 300.
Under the law, companies are required to pay the KD 50 government health insurance for their employees. Yet, there are many cases where workers are asked to pay the fee to have their visas renewed, and it is expected that firms would be more inclined to ask their staff to bear the added cost when the hike goes into effect. Even if they don’t, employees who sponsor families must still pay the health insurance for each of their respective family members. Therefore, the KD 130 fee will surely create a financial burden that far exceeds many families’ current annual budgets.
“COVID and the economic downturn have stretched many foreign workers to the limit. This new additional fee (if approved) will surely send a lot of families packing. I really wonder how a family of six will cope with rent, school fees and other additional expenses,” lamented Mahmoud Latif, an African expat.
There is also the question of how the company’s medical facilities would be able to serve the country’s entire expatriate population of over three million people, especially during the initial stage of operation. Dhaman CEO Thamer Arab said in an interview last month that the new healthcare system would help elevate the quality of services in Kuwait’s public and private health sectors alike. Pressure on Kuwait’s health infrastructure has for years been blamed as the primary cause for deteriorating health services.
This situation raises legitimate questions regarding the new company’s ability to handle the expected load on only two hospitals it plans to inaugurate before 2023. “I don’t think anything will improve. Giving the expat community only two or three hospitals will surely do more harm than good. It would have been better to scrap the issuance scheme and let them go to any private hospital of their choice,” argued Shakira, an American expat. The health ministry has not made public any details about the transition plan, such as whether it would be gradual or if part of the expatriate population would remain covered under the government health insurance program.
What is Dhaman?
Establishment in 2015, the Health Assurance Hospitals Company (Dhaman) is considered the first Public-Private-Partnership (PPP) healthcare organization in the Middle East as it was founded based on an Amiri directive as part of the national development plan ‘New Kuwait Vision 2035’.
Dhaman handles establishing an integrated healthcare system that includes medical insurance programs, as well as building and operating a network of primary healthcare centers and hospitals that cover all areas in Kuwait while applying best professional practices to achieve sustainability in healthcare and investing in the infrastructure of the health sector based on highest international standards and recruiting over 7,000 highly qualified individuals in medical and administrative fields.
The shareholder structure of Dhaman consists of government bodies represented by Kuwait Investment Authority (KIA) and the Public Institution for Social Security (PIFSS) with 24 percent, a strategic partner from the private sector with 26 percent, and 50 percent of the company’s shares were allocated for Kuwaiti citizens through an initial public offering.