Question

Which policies would you like to introduce into the health system in Saudi Arabia but which are likely to face major feasibility problem? 

Answer 1

Major feasibility problem faced by the health care sector in Saudi Arabia are:

1. HEALTH WORKFORCE

• The big and major challenged faced by Saudi Arabia is the shortage of local health care professionals such as doctors, nurses, pharmacists.
• By opening, medical schools with training program will help to overcome this problem

2. DECENTRALIZATION OF HEALTH SERVICES AND AUTONOMY OF HOSPITAL

• More autonomy has been given to the regional directories in planning, recruitment of professional staff, formulating agreements with the health care providers.
• For hospital autonomy number of strategies has tried for improving the management of public hospitals like:
  • Direct operation by the ministry of health
  • Partial operation by health care companies
  • Cooperation with other government

More autonomy to public hospitals gives more experience in the budget management, health care quality and workforce.

3. HEALTH INSURANCE SCHEME

To meet the demands of the growing population for health care, the Saudi health care market supervises a health insurance scheme.

This strategy was planned under 3 stages:

STAGE 1: includes Saudis and non-Saudis in the private sector.

STAGE 2:: includes Saudis and non-Saudis in the government sector.

STAGE 3: includes pilgrims.

4. PRIVATIZATION OF PUBLIC HOSPITALS

This is the best way to improve health care facilities in Saudi Arabia.

Advantage of privatization are:

• Quick decision making.
• Reducing governments annual expenditure.
• Producing new financial sources.

5. ACCESSIBILITY TO HEALTH SERVICES

For readily accessible health services require equity in the distribution of health care facilities and health care professionals throughout the nations.

6. DISEASE PATTERN
   • The pattern of disease changes from communicable to non-communicable.

The most effective way to reduce the prevalence of chronic disease is early prevention.

7. CRISIS PROGRAMME

To meet the crisis like fires ,earthquakes , explosions develop and implement political plans .

8. e-HEALTH AND NATIONAL HEALTH INFORMATION SYSTEM

health information system and e-health play a very important role in enhancing the quality of health care delivery, policies and infrastructure.

9. NATIONAL STRATEGY FOR HEALTH CARE SERVICES

The main aim is :

• Diversifying funding sources
• Developing information systems
• Developing a human workforce
• Encouraging private sectors
• Improving the quality of preventive, curative and rehabilitative care
• Activating the supervision and monitoring role of the ministry of health over private services

Answer 2

Ans) Saudi people seek the best possible quality healthcare and display strong feelings about certain improvements.

- The country regarding healthcare financing options and the introduction of a health insurance system to reduce the government burden and enhance sustainability, to tackles issues that should be of interest to policy makers in the KSA.

- Introducing a national health insurance system may be a viable option to finance the Saudi healthcare system, and further work is needed to confirm this on a broader scale.

- The Saudi people show a willingness to contribute to public healthcare financing on the condition that there is a clear improvement in the quality of healthcare services. There is also a willingness to contribute financially if the government is no longer able to fund healthcare services alone.

- However, it does not estimate the Saudi people’s willingness to pay, either for an improved quality of public healthcare service or to ensure sustainability of the current system. Hence, further investigation of this issue is warranted.

- It also explores public preferences regarding the financing function of the insurance system, providing a better understanding of the societal preferences of the public regarding healthcare provision and financing.

- To address the clear variation in some preferences and expectations, a new entity or independent body, built upon a partnership between public and private sectors, under government supervision, could serve as an acceptable option to the Saudi people.

- Finally, it may be transferable to other countries (especially in the Arabian Gulf region) that share similar cultural, economic and religious contexts and face similar challenges, especially with healthcare financing. As such, in terms of an original qualitative investigation, this study seeks to not only guide policy makers on the viable implementation of a national health insurance scheme but also prepare the ground for further research and public debate.

Answer 3

Ans) 1) The Saudi Arabian healthcare system is currently undergoing a process of reform. While it previously adopted a universal access approach in which all health care was provided free-of-charge to citizens at the point of care, this has been identified as unsustainable into the future.

- The shift towards an ageing population and the increasing burden of chronic disease, along with increasing use of technology and development of expensive treatments, mean that health care costs in Saudi Arabia are likely to increase significantly in the near future.

- Therefore, new ways to fund healthcare have been explored, with the solution proposed being a social insurance model in which employment contributions pay for care.

- Seeks to identify the different alternatives which are available to the Saudi government and investigate the outcomes of these alternatives in their respective countries of use.

- The private insurance system in the United States of America, the social insurance system in Australia, the United Kingdom’s National Health Service, and the Public Private Partnership adopted by Singapore. It would seem that the Singaporean model is associated with the lowest level of government spending to maintain a high quality of patient care. However, further in-depth analysis is required to better understand how this model would apply to the Saudi Arabian context.

Answer 4

Ans) The Saudi Arabian healthcare system is currently undergoing a process of reform. While it previously adopted a universal access approach in which all health care was provided free-of-charge to citizens at the point of care, this has been identified as unsustainable into the future.

- The shift towards an ageing population and the increasing burden of chronic disease, along with increasing use of technology and development of expensive treatments, mean that health care costs in Saudi Arabia are likely to increase significantly in the near future.

- Therefore, new ways to fund healthcare have been explored, with the solution proposed being a social insurance model in which employment contributions pay for ccare.It seeks to identify the different alternatives which are available to the Saudi government and investigate the outcomes of these alternatives in their respective countries of use. The private insurance system in the United States of America, the social insurance system in Australia, the United Kingdom’s National Health Service, and the Public Private Partnership adopted by Singapore. It would seem that the Singaporean model is associated with the lowest level of government spending to maintain a high quality of patient care.

Answer 5

Healthcare system in Saudi Arabia is one of the fastest-growing in the world. So in order to balance with the growth, they need some new procedures and policies to be introduced to their healthcare system. One of the major changes that the government of Saudi Arabia has to do is to introduce more foreign workforce to the healthcare system.

An increasing number of workers from foreign countries will help the country to build its economy better. But the real problem is the shortage of well-qualified nursing practitioners. They need to ensure all the required criteria during the selection of foreign workers. Further, there are problems regarding the subject of insurance coverage of foreign workers. To address these issues the country is currently restructuring the healthcare system.

Answer 6

Ans) The Saudi Arabian healthcare system is currently undergoing a process of reform.

- While it previously adopted a universal access approach in which all health care was provided free-of-charge to citizens at the point of care, this has been identified as unsustainable into the future.

- The shift towards an ageing population and the increasing burden of chronic disease, along with increasing use of technology and development of expensive treatments, mean that health care costs in Saudi Arabia are likely to increase significantly in the near future.

- Therefore, new ways to fund healthcare have been explored, with the solution proposed being a social insurance model in which employment contributions pay for care. It seeks to identify the different alternatives which are available to the Saudi government and investigate the outcomes of these alternatives in their respective countries of use. The private insurance system in the United States of America, the social insurance system in Australia, the United Kingdom’s National Health Service, and the Public Private Partnership adopted by Singapore. It would seem that the Singaporean model is associated with the lowest level of government spending to maintain a high quality of patient care. However, further in-depth analysis is required to better understand how this model would apply.

Answer 7

The policies which could be introduced into the health system in Saudi Arabia but which are likely to face major feasibility problem are :-

• Decentralization of health services and providing autonomy to the hospitals : in order to reduce the increase pressure on ministry of health, more autonomy should be given to regional directorates in terms of planning, recruitments, agreements with health service providers and some limited financial powers. Autonomy of hospitals gives them more experience in managing their budgets, workforce, and health care quality.
• Policies making health insurance mandatory to all : This could reduce the cost pressure on government since now the total expenditure on public health services comes from government.
• Privatization of public hospitals : some of the government hospitals could be sold or rented to private companies in coming years. This could help in speeding up reducing government expenditures, decision making, and improving health care services.
• Policies involving equal accessibility to health services for all : There should be equity in the distribution of health care facilities throughout the country and equity of access to health professionals and other health care services.
• Policies for implementation of promotion and prevention programmes for national crises such as wars, petroleum explosions, and natural calamities like earthquake, etc.
• Policies to increase the number of local health care professionals such as doctors, nurses, pharmacists, etc.
• Policies for introducing concepts of e-health and national health information systems.

Answer 8

Ans) Saudi Arabia will need to consider both components in any future policy changes. Analysis of the systems showed that there is little to support the use of predominantly funded healthcare models based on the experiences of Saudi Arabia and the UK.

- These models do have some advantage in that
they provide equitable access to healthcare which is free at the point-of-delivery. However, they are associated with high levels of expenditure. It would also seem that the ra-
tioning which is necessary creates a situation in which richer citizens choose to access private care available, which may then reduce the equity in the system.

- At the opposite end of the spectrum is the predominantly privately owned and funded approach adopted in the USA.

- Evidence suggests that while this approach would theoretically be most efficient, in reality it is still associated with huge government costs, due to problems with maintaining access for those in disadvantaged groups. There is also a risk that those who are less risk-averse will not take out insurance if not mandated and will then suffer financial hardship or receive poorer quality care at a later stage.

- The Australian social insurance model
seems to be associated with high quality care, which would suggest there may be some promise for the model.

- The mainadvantage is that insurance membership is mandated, with those in employment and their employers contributing most of the cost. There remains an issue of moral hazard with this approach which could see large amounts of money being
required to maintain the disadvantaged population. The only system which seems to overcome this problem is that of Singapore, which adopts a PPP approach. This would therefore seem to be the model which would allow KSA to maintain the highest level of healthcare quality while also reducing
healthcare costs.

- However, more in-depth analysis may be
required of this system to understand how it would translate to the context of KSA.

- In particular, care needs to be taken
in any system which is selected for adoption so as to reduce the risk of undoing the gains in national healthcare which have been achieved in the recent past.

- For example thereneeds to be care to retain high levels of access to primary health, particularly for children, to retain the high levels of vaccination currently observed and prevent communicable disease spread.

On the basis of the findings, the following recommendations are made:
• Healthcare reform: It is clear that the current model of Saudi Arabian healthcare is not sustainable in the future and reform of the system is necessary.
• Research: Further in-depth analysis of the Singaporean healthcare system would be useful to understanding how this would apply in the context of KSA.
• Health insurance model vs. pure privatisation:
The health insurance model which has been proposed for the KSA would seem to be preferential to the pure privatisation model adopted in the USA.

- Steps may need to be taken to reduce the risk of moral hazard as a means to curbing government spending that may still be associated with this model.

Answer 9

Healthcare in Saudi Arabia is provided free of charges to all citizens of Saudi Health services in Saudi Arabia are provided through 3 main sectors -

a) MOH network of hospitals and primary healthcare centers that have been distributed throughout the countery.

b) other government institutions

c) private sector

MOH provide largest healthcare facility in Countery providing 62% of inpatient care.

Policies which are likely to face feasibility problem --

A) Composition of health force -- Because of rapid industrialization in the country, education infrastructure has not developed as much to produce adequate number of physicians, nurses and other health care technician. Currently there are only 17% Saudi people in healthcare system. Effort should be made to involve more native people in healthcare. Local people have better knowledge of area and they will communicate easily than non Saudi people.

B) Capital investment and human resource acquisition coordination -- people in Saudi Arabia shows little interest in investment in healthcare system. There are not so much advanced facilities in the country to attract people. First of all government should encourage rich people to invest in health system, so that the standard should be raised. And there is lack of coordination between healthcare system and patient or people. So that people will come timely for regular health checkup.

C) financial support -- private hospital are receiving global budgets but the MOH network of hospitals is lacking in receiving more budget to increase standard of health care. There is competition between private and government hospital. Effort should be made to invest more in government hospital also.

D) Collaboration - To improve health facility there should be collaboration between government and private sector. But this can create a problem, to the physician and people working in healthcare system. There may be issues regarding salaries and working hours .so there should be a deal before privatization for proper functioning.