Patients must share insurance when seeking services from private health care providers: Afaal

Managing Director of ADK hospital, Ahmed Afaal on Wednesday said that there has to be a share of the patient while seeking health insurance services from private health care facilities. MD of the only private hospital operating in Maldives told Haveeru that even internationally; there are differences within the public system and the private system of providing insurance services.

“I believe that the insurance scheme should be provided free within the public sector. But there should be more arrangements if the scheme is to be provided within the private sector. The importance of it is that the public system cannot be subsidized. A budget should be allocated. Private system is one in which the funds need to be dispensed wisely. Hence these are two very different things. Hence the insurance coverage must have a share of the patient as well.” Afaal, who graduated with a Masters Degree in Health Services Management from England, said.

He said that even the people receiving health care under health insurance schemes must also be more aware.

“For instance, if a patient receives service from the private sector without a share, the budget or any government cannot sustain it. It is a very difficult job to sustain it. I would say that no country will be able to do it,” Afaal who wrote his dissertation on “Social Health Insurance System in Maldives” in his Masters, said.

He said that even if the patient has to pay a portion of the amount within the scheme, there still needs to be a plan to cushion the financial burden on the patient.

“It is common among private service providers to adopt national schemes up to its coverage and the rest is covered through private insurance scheme or can be afforded from their own pockets as it is hard to believe that it could be sustained in any other way. There should be ways for individuals to enter the scheme as well,” Afaal said.

He said that there would be differences in the prices in private and state healthcare providers.

Afaal said that as Aasandha was started, some people had misused the service, but the amount of people doing it had receded by the day.

“Hence, the best practices need to be opted while schemes are devised. There has always been a huge political influence in Maldives. They devise it as they please. Some technical expertise is available at hand. But I would like to question if it is being used to its fullest extent.” Afaal said.

He said that it is not a good thing that a basic package is not set while insurance is being provided. He added that he had previously suggested it.

“The basic package is something which offers basic services for free from anywhere. Anything over the basic services is what would be charged from your pocket or from private insurance. That is how the system should have been designed.” Afaal said.
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