Moving forward: Reforms to the health care system are expected to present many opportunities for growth

Under the Qatar National Vision 2030 – the country’s long-term development plan – the provision of a comprehensive health care system has been prioritised. As a result, the National Health Strategy 2011-16 was drawn up by the Supreme Council of Health (SCH), and is likely to see the implementation of a mandatory health insurance scheme in the very near future. Insurers are now consequently positioning themselves for this, with the widespread expectation that 2012 or 2013 could see the plan finally being put into effect.

In March 2012 the minister of economy and finance, Yousef Hussein Kamal, announced in Doha that a new law on compulsory health insurance was being debated by the Council of Ministers and might be implemented within a few months. March also saw the SCH adopt the basic regulations for a national health insurance company, which would begin employing staff and establishing itself as the leading body for the reforms.

PROVISION: According to the strategy document, some 80% of acute provisioning for health care services in Qatar is undertaken by the public sector. This is overseen by the National Health Authority (NHA), which uses the Hamad Medical Corporation (HMC) to carry out the bulk of its work. The HMC is a non-profit health care provider, established by Emiri decree. The standard of care is high, and a recent study by pollsters Gallup shows that 90% of Qatari respondents were satisfied with the health care they received – the highest rate in the Gulf. With rising costs, however, the National Health Strategy seeks to make a role for the private sector in both health care provision and financing.

The SHC has been looking at ways in which this has already been done elsewhere in the Gulf to inform its own approach. Other models used in the region include those whereby the provider and regulatory roles of the health authority are first divided. Next, a series of management contracts with private firms for hospitals are signed. Finally, complete privatisation takes place.

FINANCING: On the financing side, schemes implemented elsewhere in the region have often begun with the introduction of a mandatory requirement for expatriates to have health insurance. Coverage is then widened out to include other categories of residents, until the whole population is included. In certain countries, the roll-out period for this has been as little as two years. One way of proceeding with this has been for the government to grant a monopoly for the basic product to a particular insurer – a national company with international backing preferred, as this would bring in both local and global know-how.

PREREQUISITES: The strategy document sets out prerequisites for a compulsory scheme: implementation of an actuarial database for pricing purposes, employment of qualified staff for managing the system, safeguards to ensure high-quality, affordable health care and a full regulatory framework. On the last point, plans for the establishment of an overall insurance sector regulatory authority, announced in March 2012, will also have a bearing on the reforms (see overview).

For private insurers, the arrival of compulsory health insurance is also a potential boon. Indeed, some companies have already begun positioning themselves to take a share – Qatar Insurance Company (QIC), for example, set up Qatar Life and Medical (QLM) in 2011.

Al Koot, the captive insurer of Qatar Petroleum (QP), has also expanded its medical business beyond QP, with around 60 corporate clients now among its medical policyholders. SEIB Insurance & Reinsurance now has its most successful line of business in health. Among internationals, AXA was the largest private provider of medical insurance in 2010 and the firm is looking to expand.

Still, there are concerns within the sector over the form the new system will take. For competition to be fair and effective, safeguards may have to be employed to prevent lowered prices from driving out smaller firms and leading to a monopoly. Providing the expertise for the system to operate may take time and patience before the launch of any new programme. Nonetheless, with the government enacting reforms, the next two years could see a rise in private health insurance.