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How to fix stressed healthcare system

Overuse of the health-care system can cause problems for everyone. Fortunately, there are some remedies available.

Health care is a basic human right, a right which is recognised by Abu Dhabi's mandatory health insurance scheme. Emiratis and expatriates alike are guaranteed access to medical care - as they should be. However, as The National reported yesterday, the system is groaning, largely because the average number of hospital visits per person is much higher here than in many other countries.

Emiratis covered under the Thiqa system made an average of 14 visits to hospital outpatient departments last year. That compares to 2.8 visits in Sweden, 4.9 in the UK and 6.2 in Australia. Even after taking into account some of the salutary features of Thiqa - it offers preventive medicine, dentistry and cardiovascular screening, for example - Emiratis still present themselves at hospitals more than nine times a year on average.

As Dr Taha Ibrahim, director of Al Noor Hospital, pointed out: "Most people think that having this insurance card gives them the liberty to see the doctor." While in other countries, patients need a referral from a general practitioner to see a specialist, many people in the UAE expect to be able to walk right in the door.

Yet, as patient Nada Al Ammari told The National: "No one can restrict the number of times anyone goes to the doctor or judge whether or not someone is sick. If I feel sick and I want to see a doctor, I should have access." Given that Ms Al Ammari has Type 1 diabetes, she is absolutely right - she is entitled to the best possible care the nation can provide. But for that to happen, it means that people who do not need to see a doctor must not clog up the system.

This is not a problem restricted to the UAE. Among solutions in other countries has been the establishment of telephone hotlines and websites where doctors and nurses are on hand to give basic advice and recommend whether hospital treatment is really required.

It may also be necessary to introduce a co-payment system, as is the case under many health plans for expatriates. The thought of having to pay even a token amount may help dissuade those who are not truly ill from exercising their right to hospital care.

The upshot is that if the system cannot cope, something has to give. The quality and availability of care will inevitably suffer if something is not done.

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