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Sunday, August 1, 2021

Qatar’s universal healthcare scheme Seha marks one year since launch

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It’s been one year since the launch of the first phases of Qatar’s new universal healthcare scheme Seha, a program that has elicited mixed reactions from residents.

So far, Seha can only be used by the local population.

Over the past year, almost 230,000 visits have been made at various hospitals and clinics from Qataris using Seha services, according to the Qatar National Health Insurance Company (NHIC), which is tasked with implementing the program.

In a statement, Dr. Faleh Mohamed Hussain Ali, acting CEO of NHIC, said:

“The past 12 months have been a tremendous success for the National Health Insurance Company. The fact that the scheme’s roll-out has been both smooth and on time is a significant achievement and testament to Qatar’s progress toward realisation of the National Vision 2030 and modernization of the healthcare sector as envisioned by the National Health Strategy.”

Successes

So far, four private hospitals (Al Emadi Hospital, Al Ahli Hospital and Doha Clinic) have joined Seha’s provider network.

Today, Qataris have free access to healthcare at over 60 medical facilities, including seven hospitals, 29 clinics and polyclinics and 43 dental providers (of which 27 are specialized dental centers and one optical provider with six branches).

NHIC has announced that a second optical provider, Al Jaber Opticians, will join the Seha network this month, offering an additional 20 healthcare centers. By the year’s end, NHIC plans to have some 100 providers in its network.

A full list of the current providers can be found on Seha’s website.

In addition to healthcare treatment, Seha has introduced two management programs to help educate and support the local community.

The Maternity Management Program was introduced in October under phase one of the scheme. Through the program, Qatari women have the option of receiving a support network for any concerns or questions they have about pregnancy.

The second program is the Diabetes Management Program, introduced in May this year under phase 2. This program offers education and support to help those who have been diagnosed with Type 1 and Type 2 diabetes. According to NHIC, 78 percent of Qataris who have been advised to attend the program have enrolled.

Complications

While the new health scheme has been successful in taking off, with a significant number of Qataris using its services, service providers have consequently claimed to be “overwhelmed,” according to Dr. Faleh Mohamed Hussain Ali, acting CEO of the NHIC.

Speaking to Doha News in April, Ali said that there was a lack of unpreparedness from certain service providers, resulting in long queues and displeased patients:

“We told them from the beginning that our base of customers is going to be the entire nation. So I think they didn’t actually do their homework properly and they were not ready to actually realize how much pressure is going to be there in the system.”

For the past several months, residents have turned to Twitter to express their frustrations toward hospitals covered under Seha:

Dr. Islam Zakaria, manager of Doha Clinic, previously told Doha News that the facility has seen a “vast increase” in the number of Qatari patients coming through its doors:

“The new scheme has affected our planning, and we have had to adapt in many ways, by hiring more staff to deal with the increase of patients. Our prices are also being studied and adjusted.

There are positives and negatives to the new scheme, but the staff are trying their best to serve all of the patients efficiently as well as deal with the structural changes.”

However, it seems that providers are getting better at dealing with the influx of patients over time, with residents recently expressing more encouraging experiences:

https://twitter.com/mehmetalkacar/status/500344054316417025

But many are still upset with the general service they receive at medical centers across Qatar, including those associated with Seha:

https://twitter.com/mattgronseth/status/500344959568859137

Seha services

Seha was launched after the Emir passed a Law No. 7 of the Social Health Insurance last June. The new legislation will eventually make it mandatory for all residents and visitors of Qatar to be covered by a health insurance plan.

Over the next two years, employers and sponsors will become responsible for paying the insurance premiums of their foreign employees and families.

Qataris continue to receive free healthcare, but now have a greater choice of facilities to frequent.

Before Seha, Qataris without health insurance could only receive free treatment at government institutions. Through Seha, they are now able to receive care at a number of private hospitals and clinics.

Implementation

The Supreme Council of Health (SCH), who is regulating the scheme, previously announced that the implementation of the universal health scheme will be broken down into five phases, the final phase rolling out by 2015:

Phase one

Seha’s first phase made its appearance in July last year, focusing on improving the healthcare of Qatari females. Those aged 12 years and above (totaling around 90,000 people) were able to receive free health care for maternity, obstetrics and gynecology and other female-related health issues from eight hospitals.

Phases two and three

In April, the second and third phases took effect, so that all Qataris are now included under Seha.

This means that locals are covered for inpatient and outpatient services, including preventive care, emergency treatment, physiotherapy, basic and emergency dental care, occupational therapy, speech therapy, long-term care, radiology, ophthalmology, laboratory testing and prescription medicines.

Seha does not cover the cost of most cosmetic surgeries, however.

Dental care has also recently been added to the list of free services. Seha covers all basic and emergency dental procedures, but certain procedures require prior approval from NHIC as well as a second opinion from a member of the Panel of Experts nominated by the Qatar Council of Health Practitioners. Such treatments include indirect veneers, tooth implants and orthodontic procedures.

Purely cosmetic procedures, like teeth whitening, are not covered by Seha.

Phases four and five

The final stages of implementation are expected to be introduced by next year, meaning everyone in Qatar will have the option of choosing between public or private health facilities with no additional costs.

The fourth phase focuses on ensuring white-collar expats and visitors are covered by the scheme.

The fifth and final stage will bring blue-collar expats under Seha’s umbrella. This would give them access to Hamad Medical Corp. hospitals, additional private providers and three new single male laborers’ hospitals that have yet to be built.

Thoughts?

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LISA BETTY
LISA BETTY
6 years ago

Plans have now been postponed for at least 18 months to allow the National Health Insurance Company (NHIC) to try to tackle some of the many problems the implementation of the scheme has raised, including overcrowding at private hospitals

http://healthcareadmin.org/

laureen
laureen
6 years ago

The value of health insurance premiums has yet to be determined, but will be set according to generally accepted actuarial principles, and without discrimination between beneficiaries in respect of age, gender, previous health status or any other risk factors.

HCG

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