Moving from free health care system to private health insurance in the Kingdom of Bahrain. Public perception and cultural readiness.

Presenter: Lameea Al-Tahoo, Ministry of health

Abstract

Rational: Since the establishment of formal healthcare system in the kingdom of Bahrain, population has enjoyed free comprehensive health care. Such a universal coverage of public health has lead to major achievements manifested in health status of high standards, life expectancy of 74.8 years. In light of the consciously escalating cost of health care, it is a known fact that no public health system can afford to continue to offer free comprehensive health services without compromising on quality and standard of that care. The Kingdom of Bahrain is no exception. Especially in light of the questioned capacity of oil revenue to continue to sustain government income at a similar level in the future. A private health insurance system is under consideration by the government. However, moving from totally free health care services to a health insurance system holds several challenges; the least to mention is cultural readiness and societal acceptance of the change.

Objectives: The objective in this paper is to explore the public perception of the upcoming reform and to examine some of the cultural and societal assumptions of various stakeholders. The ultimate aim is to formulate an idea about cultural readiness for such reform.

Methodology: There will be an examination of public perception of the advantages and disadvantages of the upcoming health financing reform. Various stakeholders' response will be compared on the basis of benefits, risks and expected outcome. Both quantitative and qualitative research methodology are being used to understand different categories perception, understanding and readiness.

Result: The overall preliminary result suggests that a cultural and societal readiness might represent a real challenge. Resistance to the new system could influence utilization and would potentially affect the heath status of the population.

Conclusion: The ambition among the health providers group is that a national reform toward health insurance will enhance efficiency and effectiveness of the health system, will assure sustainable financing system and would contribute to the recently growing national orientation toward privatization of public services. This however contradicts with public perception of the upcoming system as a mean to increase government revenue. A general lack of awareness of the potential risks and benefit of the system has been demonstrated. The question of the suitability of the private health system as the desirable alternative by the government has been raised. An important consideration when introducing a new way of financing is to understand the challenges that could jeopardize the health status of the population. Among the many of those challenges is cultural readiness and trust in the system. If the government is to go ahead with the implementation, a major step would be is to address cultural assumptions and to assess awareness. Results could be utilized in designing programs to create awareness and aid in the implementation process.