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reply for dr
You mention the different types of insurance in the KSA and the services they offer. My follow-up
question is as follows: What are the deficiencies in available coverage that need to be addressed into
order to meet the Vision 2030 goals?
Again, good job.
-Dr. Robert
reply 2
2 days ago
SHATHA BAZHAIR
healthcare contracts
COLLAPSE
An efficient contract management system in Saudi Arabia’s healthcare industry can
lead to numerous benefits, such as better patient care, reduced operational expenses,
and maintained service access (AlNemer, 2018). Insurance policies generally oblige
insurers to cover the insured’s healthcare expenses for a premium paid by the employer.
In Saudi Arabia, the policy’s conditions govern the rights of the parties involved in the
insurance contract, and the policyholder is responsible for paying the premium.
In Saudi Arabia, employers are required to provide insurance coverage for their
employees and dependents, including foreign workers, who must be covered by the
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Saudi social insurance system. Individuals who are not covered by an employersponsored plan, such as residents and citizens, can purchase individual health insurance
policies from a licensed provider (O’Brien, 2003). These policies typically pay for
hospitalization costs and may also include coverage for specialist and follow-up medical
appointments, as well as prescription drugs. Pre-existing conditions are normally
covered under individual health plans, and the waiting period varies depending on the
policy.
Health plans in Saudi Arabia consist of three parties: Policyholders, insurance
companies, third-party administrators, and service providers. All contracts are set
within specific regulations outlined by each plan and overseen by the Council of
Cooperative Health Insurance (“Implementing Regulations of the Cooperative Health
Insurance Law,” 2014).
A well-managed healthcare system can also benefit the government, as healthcare
spending has increased in recent years. The cooperative health insurance program can
lessen the financial burden on the government money, allowing more resources to be
allocated to other critical industries such as education (Al-Hanawi et al., 2017). Overall,
the program aims to promote long-term public development.
Employers in Saudi Arabia are advised to insure their employees with a licensed
provider, as it adds value in retaining employees and improving their health and
productivity. Employee health insurance is similar to individual health insurance and
typically covers hospitalization costs. Some employer-sponsored health plans may also
include coverage for specialist and follow-up medical appointments. Pre-existing
conditions are usually covered under employee health plans, with the waiting period
varying depending on the policy.
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In summary, it is critical to have an efficient healthcare insurance system. This includes
streamlining the process of creating, routing, reviewing, and approving contracts,
ensuring compliance, and reducing risks. An effective healthcare insurance system can
also play a vital role in improving patient outcomes, reducing operational costs, and
contributing to long-term public development.
References
AlNemer, H. A. (2018b). Perception of the Benefits and Features of Health Insurance
Policies Offered by the Employers: Empirical Findings from Saudi Arabia.
International Journal of Business and Management, 13(6), 214.
https://doi.org/10.5539/ijbm.v13n6p214
Al-Hanawi, M. K., Alsharqi, O., Almazrou, S., & Vaidya, K. (2017). Healthcare finance
in the Kingdom of Saudi Arabia: A Qualitative Study of Householders’ attitudes.
Applied Health Economics and Health Policy, 16(1), 55–64.
https://doi.org/10.1007/s40258-017-0353-7
Implementing Regulations of the Cooperative Health Insurance Law. (2014). In CCHI.
Council of Cooperative Health Insurance. Retrieved September 18, 2023, from
https://chi.gov.sa/en/AboutCCHI/Rules/document/Implementing%20Regulations%20of
%20the%20Cooperative%20Health%20Insurance%20Law.pdf
O’Brien, E. (2003). Employers’ Benefits from Workers’ Health Insurance. Milbank
Quarterly, 81(1), 5–43. https://doi.org/10.1111/1468-0009.00037
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reply 3
3 days agoUser’s profile pictureEBTEHAL BAAWADH
Benefits of Healthcare Contracts.
COLLAPSE
In Saudi Arabia, contracting for healthcare involves multiple parties,
including the employer, employee, and residents. There are several
benefits associated with these contracts that positively impact each party
involved.
For employers, contracting for healthcare in Saudi Arabia can provide
various advantages. Firstly, it allows them to offer comprehensive health
coverage to their employees, which is an essential factor in attracting and
retaining high-quality services. By providing healthcare benefits,
employers can demonstrate their commitment to the wellbeing of their
staff, thus fostering a positive work environment (Al-Hanawi, et al., 2020).
Moreover, contracting for healthcare can help employers manage costs
effectively. Through negotiations with healthcare providers, employers can
secure favorable rates and packages, leading to potential cost savings.
Additionally, these contracts often include preventive measures and
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wellness programs, which can increase productivity among employees (AlHanawi, et al., 2020).
Employees, on the other hand, benefit greatly from healthcare contracts. Such
contracts ensure that individuals have access to necessary medical services
without facing excessive out-of-pocket expenses. It provides a sense of
security and peace of mind, knowing that their healthcare needs are
covered by their employers (Alkhamis, 2017). Furthermore, healthcare
contracts often encompass a wide range of services, including routine
check-ups, emergency care, medication coverage, specialist consultations,
and hospitalization. This comprehensive coverage allows employees to
receive timely medical attention, promoting better overall health and
addressing potential health issues before they worsen (Alkhamis, 2017).
Regarding resident requirements, healthcare contracts play a crucial role in
ensuring access to quality healthcare for all residents in Saudi Arabia.
Residents who are not employed or sponsored by an employer can obtain
private health insurance directly or avail themselves of governmentsponsored health insurance programs, such as the Cooperative Health
Insurance Council (CHIC). These programs aim to provide affordable
healthcare options for residents, ensuring equitable access to necessary
medical services (CHIC, n.d.).
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It is essential to note that specific requirements may vary depending on the
contractual agreements, such as the extent of coverage, eligibility criteria,
and copayment obligations. Nevertheless, contracting for healthcare in
Saudi Arabia generally benefits employers, employees, and residents by
ensuring easy access to quality healthcare services, promoting well-being,
and complying with legal obligations.
References:
Al-Hanawi, M. K., Almubark, S., Qattan, A. M. N., Cenkier, A., & Kosycarz, E.
(2020). Barriers to the implementation of public-private partnerships in
the healthcare sector in the Kingdom of Saudi Arabia. PLOS ONE, 15(6),
e0233802. https://doi.org/10.1371/journal.pone.0233802
Alkhamis, A. (2017). Critical analysis and review of the literature on healthcare
privatization and its association with access to medical care in Saudi
Arabia. Journal of Infection and Public Health, 10(3), 258–268.
https://doi.org/10.1016/j.jiph.2017.02.014
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Cooperative Health Insurance Council (CHIC). (n.d.). Implementing Regulations
of the Cooperative Health Insurance Law. Retrieved September 19, 2023,
from
https://chi.gov.sa/en/AboutCCHI/Rules/document/Cooperative%20Health
%20Insurance%20Policy%20Approved.pdf
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