x Abu Dhabi, UAESunday 21 January 2018

Our health care system should give equitable access to all

The rise in health care costs and the introduction of health insurance are two factors that seem to be creating an uneven system of care, writes Maryam Islamil

Islamic history is filled with great lessons that are worth rediscovering and implementing today – especially in the field of health care.

In 10th century Cairo, Ahmed Ibn Tulun built the first centre for healing and care using medicine and nutrition to cure the sick.

In 1284, Al Mansur Qalawun founded a hospital in Cairo after receiving excellent treatment at an established centre in Damascus. He gave access to health care to all in Cairo, without making a demand for payment.

This example was the guiding principle of health care in the UAE for decades. People were served together regardless of status, each getting the best care possible. My family was a benefactor of this “amanah”, or caring trust.

But times are changing or, as one UAE resident told me: “Before, you only paid Dh100 and you could go to any hospital you wanted to and get everything you needed.”

Some hospitals now require deposits as high as Dh10,000 prior to admission and if you don’t have the money, you must hand over your passport as security.

The rise in health care costs and the introduction of health insurance are two troubling factors that seem to be creating an uneven system of care similar to that of the United States, where there have been decades of false steps leading to millions going without the proper care they need.

Last October, the annual fee for the Government healthcard was raised in the Northern Emirates to Dh370 for adults and Dh150 for children. This card used to be optional, but now it is mandatory.

With it, you have access to the Government clinics, hospitals and general practitioners as well as specialists, for which the fees per visit have also increased.

“It’s too expensive now. A visit used to be Dh50, now it’s Dh350,” one patient told me. It must be noted, however, that these fees do not apply in Dubai and Abu Dhabi as each of these emirates follows its own system.

And even with this new framework in place, many people have uneven access to health care. These new changes have made Government clinics and hospitals less attractive especially in Sharjah, where, in some cases, Government-run facilities are now more expensive than equivalent private ones.

A small-business owner who was struggling to find the money to buy health insurance for his family told me: “Everyone should be covered. The heat should not be on the individual.”

He is a multiple-emirate entrepreneur whose residency visa was issued in a different emirate to the one in which he lives and works. This meant that he ended up purchasing health insurance from the UK for his daughter as he could not afford the Dh15,000 annual premium required for entrepreneurs.

In 2009, the consultancy firm Grant Thornton undertook a study of health care in the GCC.

The report highlighted the billions of dollars that can be earned in the sector, but when analysing the industry in the UAE it also found two worrying trends.

The Grant Thornton report found that “there is an insufficient local population willing and able to undertake the training required to generate extra health care professionals”. It also noted a general lack of confidence in the health care system.

This lack of trust was recently highlighted by Ali Eisa Al Nuaimi, a Federal National Council member for Ajman, who called for more money to be made available to send nationals abroad for medical care.

These divergent factors combined highlight the need to re-examine how to provide care and how it best serves both citizens and residents.

The Grant Thornton report also stated that “a health care system must allow an equitable access to care”.

History teaches us that in Islamic culture that is possible. It is time to think of a new socially just Islamic growth model – one that can sustain the UAE economically and socially in this world and the hereafter.

Maryam Ismail is a sociologist and teacher who divides her time between the US and the UAE

On Twitter: @supermothersoul