KUWAIT: Nearly 3 million expatriates may face difficult healthcare challenges in three years’ time under a proposed government plan to close access to public health services. Government officials recently suggested that a timetable has been established for the creation of expat-only hospitals accessible by higher-cost private health insurance. The shift would create a cascade of consequences for expatriates and citizens in Kuwait as well as the local public and private health sector.

Plans on paper
The Health Ministry is already making plans for a possible eventual ban on expats using public health facilities. “There are two categories of expatriates in Kuwait,” said Dr Khaled Al-Sehlawi, the ministry’s undersecretary was quoted in a local Arabic daily yesterday. “The first includes nearly 2 million foreigners working in the private sector. If the current health insurance is canceled, they will be treated at the health insurance hospitals that will be built within three years.”

Already there are plans in the works to establish expat-only hospitals. In 2014, the government established a shareholding company to build three 700-bed hospitals and 15 polyclinics to provide integrated medical services to foreigners in Kuwait. The company was established according to the public-private-partnership (PPP) model with a KD 230 million capital. The government owns 24 percent of the company’s shares, while 26 percent are owned by strategic investor, Arabi Holding Group. The remaining 50 percent will be offered in an initial public offering.

A second class of foreigners, those who work in the public sector as well as domestic servants, will possibly fall under an alternative health plan. This group, approximately 1 million foreigners in Kuwait fall into this category, would be treated in private medical facilities. The exact mechanism for providing them health insurance coverage, however, is unclear.

Last week’s news also raised questions regarding the capability of the private health sector in Kuwait to absorb the large number of expatriates expected to be shifted there once health insurance is canceled. Sehlawi reassured that the private medical sector is ‘well prepared’ for that task.

Timetable
The three-year timetable that Sehlawi mentioned seems to give an indication of when the government might seriously consider closing access to the public health services to expatriates. When the new hospitals are established, expatriates’ annual health insurance fee is expected to triple to not less than KD 150 compared to the current KD 50. Furthermore, the current plan indicates that foreigners will have to purchase the health insurance policy from the same company in order to have access to medical services at the three hospitals, unless plans change. Whether buying this specific policy would be mandatory or expatriates would be given the choice to purchase policies from other insurance companies is not yet known.

The recent developments come as the cabinet has reportedly assigned the finance ministry, oil ministry, commerce ministry, General Secretariat of the Supreme Council for Planning and Development, Fatwa and Legislation Department and the privatization bureau to study a recommendation made by the Supreme Council for Planning and Development (SCPD) to cancel subsidization of health services for expatriates.

The recommendation came in a recent study for the SCPD on ways to reduce the government budget in light of the drop in oil international prices. The report has described expats’ health insurance as ‘harmful subsidies’ to the state budget, and suggested imitating an example followed in the 1990s when the Kuwaiti government scrapped free education for expatriates, thus banning foreigners from studying at public schools and forcing them to enroll in private schools.

The action led to a boom in the private sector and the skyrocketing of private school tuition fees. The consequence of this, however, impacted both locals and expats as many citizens also send their children to Kuwait’s private schools.

By Ahmad Jabr