Role of Insurance in Managed Care in UAE

Introduction

Health care is a very important consideration for every government across the world. Generally, health care is quite broad and involves numerous stakeholders, including doctors, nurses, dieticians, and therapists among others.

This paper looks at the role of insurance in managed care in the United Arab Emirates (UAE) and is based on an article by the U.S.-U.A.E. Business Council.

Why did you select the Article and do you see it as Relevant?

The choice of the article by the U.S.-U.A.E. Business Council is informed by the fact that the article presents an elaborate discussion about the health care sector in the United Arab Emirates and how it has developed over the years to be among the world’s well-managed health care system. From having only 12 health centers to serve the entire population, the U.A.E. today has more than 70 public and private hospitals as well as 150 centers and clinics that are devoted to providing primary health care to all citizens (USUAEBC, 2016). Further, the article is relevant to this discussion since it also looks at critical players in the U.A.E. health care sector such as Daman.

How does the Article Link to Supply and Demand for Health Services

Right from the start, the article offers an introduction that makes it easier for readers to understand the health care sector in the U.A.E. Drawing from the discussion in the paper, it is clear that the health care sector in U.A.E. has continued to grow. The article also highlights the role played by the United States in building and strengthening the health care sector in the U.A.E. from infancy.

As noted by USUAEBC (2016), the involvement of the United States in promoting health care in the U.A.E. created opportunities for strong partnerships to be developed between companies in the U.S. and U.A.E. Undoubtedly, strengthening these ties will be beneficial to the U.A.E. as the country’s population continues to grow with an increase in the need for universal health care for everyone.

What Decree Created Daman and how is this Important?

According to USUAEBC (2016), Daman was created by Emiri Decree No. 39 of 2005 to address the health care needs of the people of the U.A.E through a program known as Thiqa. The government of Abu Dhabi has an 80% stake in Daman while 20% is owned by Munich, a private investor. Daman is fully responsible for the provision of affordable health care services to more than 2.8 million members in U.A.E. Apparently, a huge percentage of those who benefit from Daman are low-income expatriates who live in the country (USUAEBC, 2016).

The establishment of Daman is very fundamental to the provision of reasonably priced health care services to the people of the U.A.E. This is particularly important considering that many people may not be in a position to access health care services without receiving support from the government. Through the Thiqa program, members would be required to pay up to 20% of the cost of treatment at private hospitals. However, treatment at public facilities would be provided to members at no cost.

With an Example, Explain why Cost-Benefit Analysis is Relevant to the Article

For the health care program to be successful, stakeholders must plan effectively. A cost-benefit analysis is certainly important as it will make it possible for health care planners in U.A.E. to have a clear picture of what to expect in terms of cost and possible benefits that can be realized. Using the growth in population as an example, a cost-benefit analysis will be beneficial in understanding possible challenges and how we’ll deal with them if they are encountered.

Considering that a high number of people may end up being enrolled in Thiqa as a result of growth in population, for example, the initial cost of reforms to the program may be quite prohibitive. The initial investment cost will however bear fruit in the long run once stability is realized.

The issue with Demand Growth in the UAE

As the population of the U.A.E. continues to swell, it is obvious that there will be an increase in demand for health care services in the country. Consequently, the government has to do everything within its powers to put in place vital mechanisms that will guarantee easy access to health care services for all.

As argued by USUAEBC (2016), it is very likely that without an effective strategy in place to cater for the health care needs of a rising population, some people may become disgruntled and opt to seek health care services outside the country.

Why we need to be concerned with the Issue within the Article

A central theme in the article by U.S.-U.A.E. Business Council is the need to strengthen the health care sector in the U.A.E. to ensure that people have access to health care services at reduced costs. In the absence of a well laid out plan to deal with the health care needs of the people of the U.A.E. the problem will eventually get a hand.

Without a good health care plan in place, the population of the U.A.E. will be in a poor state and may become a burden to the government. To develop, every government requires citizens to be actively involved. However, this can only happen when a country has a healthy population. For this reason, the government of the U.A.E. must do everything possible to ensure that the existing health care system is strengthened and that individuals can access health services easily when needed. A healthy nation will in turn provide the energy required to move the country to greater heights.

What is the Role of Policy here and in the Control of Healthcare?

Generally, health care policies are intended to be part of a large process that is meant to ensure that a government can deliver health care services as required. Among other benefits, health care policies will see to it that resources in the health care sector are put to good use. Also, policies will compel medical practitioners to make every effort to provide quality services to clients.

In the article, policies will help to lay a good foundation for companies from the countries involved to have healthy relationships that will eventually lead to improved provision of health care services. Policies will also guarantee the proper use of resources and reduce any form of friction that may threaten the success of the health care plan. Also, policies as well as in the health care sector will force individuals to carry out their daily operations based on standards.

Two ways Insurance will Impact on Healthcare

A major role of insurance in health care is to safeguard the interests of the insured parties. This section presents two ways through which insurance impacts on health care.

First, insurance provides a means through which low-income earners in society can meet their health care requirements. When an insured member of any given society requires access to treatment, insurance companies can intervene and help to meet the cost of treatment at subsidized rates. Without a doubt, this helps to speed up the healing process.

Secondly, insurance helps to reinforce quality in the provision of health care services. With insurance companies all over, medical facilities can focus on delivering quality services while the insurance companies guarantee payment for services rendered.

Why is Coding Errors an Issue in Healthcare here?

Coding errors in the health care sector are common and can result in numerous problems either to a client or health care provider. For example, changing a code associated with a certain service can cause a health service provider to charge a patient for a service not rendered. Coding errors can also lead to cases where items meant to be billed together end up being billed separately. This may cause a client to pay more than expected.

It is therefore necessary for coding professionals to eliminate or avoid coding errors as much as possible. Health care providers must create time to specifically examine suspect processes and ensure that they generate the correct outputs.

Conclusion

As has been explained in this paper, insurance plays a very critical role in managing health care not only in U.A.E. but in other countries as well. It is, however necessary for all stakeholders to join hands and ensure that people can access health care services at reduced costs.

Reference

U.S.-U.A.E. Business Council (USUAEBC). (2016). The U.A.E. Healthcare Sector: An Update. Web.