With reporting from Chantelle D’mello

As Qatar’s National Health Insurance Co. (Seha) services end today, Qataris will be entering the new year with very little information about what comes next in terms of their medical coverage.

Last week, the Supreme Council of Health announced that its insurance scheme for nationals would be suspended by year-end and eventually handled by private insurers.

Yesterday, the country’s Cabinet formally annulled Seha during its weekly meeting.

According to QNA, it amended aspects of the social health insurance system law (No. 7 of 2013) to end Seha and to allow private insurance companies to provide insurance coverage services to residents.

Also yesterday, the SCH said in an update that it would begin the tender process for private insurance companies to bid to join the new system in February.

Assessment of bids, selection of the company or companies and signing contracts will be done in May, and the Cabinet will set up a special committee to oversee the work, the SCH added.

Qataris should be able to use the new system June 1.

There has been no announcement yet on what, if any, coverage will be provided for Qatari patients between the end of Seha today and the start of the new system in six months.

However, in its statement, the SCH said that private hospitals have been contacted and told to continue treating patients who had already been admitted before the Dec. 31 cut-off date. Such patients can undergo medical care even after today, SCH added.

Belt-tightening

Under Seha, Qatari nationals could access medical treatment at a range of private clinics, hospitals, health centers, opticians and other service providers across the country who had signed onto the system.

The government picked up the bill for its citizens and since the launch of Seha in August 2013 has processed more than 1 million patients, NHIC acting CEO Dr. Faleh Mohamed Hussain Ali said earlier this year.

With an estimated Qatari population of around 300,000, this equates to more than three visits per person.

In October, public health minister Abdullah bin Khalid Al-Qahtani said that in the 15 months since the scheme began, Seha has paid out nearly QR1.3 billion for patient care.

No official reason was given for the ending of Seha, but many Qataris have hailed the decision because they believed private clinics were cheating the system.

The ending of the program comes into effect a day before the start of the new fiscal budget, which includes a significant cut in expenditures.

Thus, the new system could be part of an overall belt-tightening that is taking place across all government sectors.

Demand

Before Seha, Qataris could only get free treatment at a limited number of state-run hospitals and clinics. But many began going to private hospitals and clinics once they began accepting the new coverage.

Speaking to Doha News, managers at some private hospitals with Seha said they have seen a huge influx of Qatari patients ahead of today’s cut-off date for the insurance scheme.

A representative at Doha Clinic in Al Sadd said:

“Yes, we have seen an increase in patients. Many people call us up asking to clarify rumors that they’ve heard about Seha ending. Once we say that it is being scrapped, they then schedule appointments. It makes sense that people want to take advantage of it before it ends.”

Other clinics, such as Al Aqsa Medical Center, said they have switched to a cash-only payment system since the announcement.

Dr. Hanan Abu Ajina, clinic owner and director, said the clinic would try to continue providing services to Seha patients after the New Year to avoid interrupting their treatment, Qatar Tribune reported.

While more than 200 private clinics joined Seha, participation was not obligatory and some, including American Hospital on C-Ring Road, chose not to take part.

Queen Medical Group was another private provider that did not join the scheme. Dr. Mamdouh Fared, founder and CEO said this was for a number of reasons, including a lack of enough employees to meet demand, the Tribune added.

As Seha was rolled out to an increasing number of Qatari citizens, participating private clinics began to feel the strain, and crowded waiting rooms and long lines became commonplace.

Shifting trends

Speaking to Doha News in March this year, a senior doctor at Doha Clinic said that since the launch of Seha, the facility had seen a shift in the demographics of its patients. Insurance manager Dr. Islam Zakaria said:

“Before Seha, most of our patients were cash patients. Now many of these have been replaced by Seha patients, who make up 40 percent and sometimes up to 50 percent of our total number.

These are new, Qatari patients who didn’t come to us before, but have transferred from Hamad (Hospital),” he continued.

Zakaria said that at the time, the hospital was operating at capacity with the services provided by some departments – namely emergency, pediatrics and obstetrics and gynecology – in particularly high demand.

The original plan for Seha was that it would be rolled out in stages, ultimately providing coverage to all Qatar residents, although employers were to be responsible for paying the insurance costs for non-Qataris.

While the scheme was extended to cover all Qataris, plans for coverage for expats began to stall earlier this year.

Foreigners and visitors to Qatar were initially supposed to come under the system this year. White-collar workers would have been the first to get on Seha, followed by blue-collar employees and then domestic staff.

However, Al-Qahtani announced in October this year that there would be a delay and that all expats would have insurance coverage next year. Whether this remains the case is unclear.

Thoughts?