The Bahraini government’s new law mandating that health insurance cover be provided to all citizens, residents and visitors in the country will begin in January 2019. This may be optimistic.
The health insurance plan must cover benefits that the government will announce, which will depend on the foreign national’s category. In terms of cover:
- The Bahraini government will provide cover for all Bahraini citizens
- Employers will need to enrol foreign employees (and their dependents)
- Visitors, including tourists, must have health insurance
Whether Bahrainis will be allowed to go to another country for treatment at state expense is still undecided. Much of the detail is still being negotiated between various government and health bodies, and insurers, so actions could change. Add in a struggling economy due to shrinking oil production, and the stated January 2019 start looks very optimistic.
The list of approved health insurance providers is yet to be published. Employers can only use listed allowable insurance providers once the government publishes this information. The Supreme Council for Health and the National Health Regulatory Authority are in talks with private hospitals and clinics, so people can be treated there as well as in government hospitals.
Clinics could soon open at Bahrain’s main public hospital as part of the national health insurance scheme. Doctors working for Salmaniya Medical Complex (SMC) will have the freedom to open their own clinics inside the facility, but will not be able to establish private clinics outside the hospital. This is part of a major plan to turn SMC into an autonomous body, free from the governance of the Health Ministry.
The National Health Insurance Scheme (Sehati), aims to build a patient-centred system with high quality standards, in line with Bahrain’s National Health Plan. Covering locals and expatriates, the health insurance plan will promote a competitive market between hospitals and insurance companies.
Under the new National Health Insurance Law, Bahrainis will be able to seek certain medical services for free at government owned facilities. Those choosing private sector hospitals or clinics will have to pay no more than 40% of the cost, with the government picking up the balance. GCC citizens, expatriates married to Bahrainis and children of Bahraini mothers will receive the same benefits.
Expatriate domestic workers, including housemaids, drivers, gardeners and nurses, will be covered for free under the scheme.
Other expatriates will have to contribute to their medical costs in 16 of 19 set categories (excluding primary and limited secondary healthcare and emergencies) since they will enjoy only partial health cover, paid for by their employers.
Charges for expatriate health insurance will be made through the Labour Market Regulatory Authority when work permits are issued or renewed.
The law also paves the way for a new National Health Insurance Authority that will invest funds to generate income and will also accept donations.
Adding to the problem of implementation is that the government has not yet worked out how to pay for the free cover. Once a rich oil economy, the economy is now struggling and actually shrank on an annual basis in the first quarter of 2018 for the first time in at least seven years, hit by a fall in oil production. Bahrain has a current account gap and a large state budget deficit, as the various sectors seeking to replace the oil-based economy, such as tourism, fail to grow.
Bahrain is one of the most vulnerable and smallest of Gulf Arab economies and has suffered badly as the oil boom has ended. The IMF has warned that Bahrain needs a comprehensive package of reforms to reduce its fiscal deficits over the medium term and bring down spending, while reducing subsidies. It wants Bahrain to bring in direct and corporate taxation, and other reforms that it has long promised but failed to deliver.