Dubai’s health cover raises its own challenges



The introduction of compulsory health insurance for every worker in Dubai is good news for everyone, because it will enhance the health care system in the emirate and provide a better health security for residents.

But as it is the case with any new initiative, it also raises its own set of challenges.

As The National reported yesterday, the new scheme that will be rolled out in phases from next year to mid-2016 will require employers to provide health insurance to workers, as well as their employees' spouses and children, for as long as they live in the emirate.

Failure to do so could lead to fines of between Dh500 and Dh150,000, and up to Dh500,000 in case of repeated breaches. Domestic staff and visitors will also be covered in later stages.

Health insurance is important, especially for those unpredictable moments in life.

In Abu Dhabi, making health insurance mandatory for residents helped many to ensure they received the necessary medical treatment. After more than four years, 98 per cent of Abu Dhabi workers are covered.

But the emirate also faced some challenges with the increasing demand, causing the overall cost of medical treatment to go up. The government addressed that costs blow-out by cutting the prices of more than 6,600 medicines by up to 40 per cent.

The lack of public information on the correct use of health insurance, the absence of unified guidelines for treatments, low responsibility by members on sharing the cost of treatment, and insufficient management of the dispensing of pharmaceuticals were identified by Daman, the main health insurance company in Abu Dhabi, as some of the main factors that led to inflation and health insurance abuse.

Dubai is likely to face the same challenges, which is why lessons should be learnt from Abu Dhabi’s experience.

The proper supervision of the insurance system is necessary to avoid abuse and fraud.

An awareness campaign is also required to educate the public about when they should seek medical help. Having a well-informed public will help to address many problems.

Abuse of the system by a few will reduce the benefits – and raise the cost – for all.

Prophets of Rage

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Mercer, the investment consulting arm of US services company Marsh & McLennan, expects its wealth division to at least double its assets under management (AUM) in the Middle East as wealth in the region continues to grow despite economic headwinds, a company official said.

Mercer Wealth, which globally has $160 billion in AUM, plans to boost its AUM in the region to $2-$3bn in the next 2-3 years from the present $1bn, said Yasir AbuShaban, a Dubai-based principal with Mercer Wealth.

Within the next two to three years, we are looking at reaching $2 to $3 billion as a conservative estimate and we do see an opportunity to do so,” said Mr AbuShaban.

Mercer does not directly make investments, but allocates clients’ money they have discretion to, to professional asset managers. They also provide advice to clients.

“We have buying power. We can negotiate on their (client’s) behalf with asset managers to provide them lower fees than they otherwise would have to get on their own,” he added.

Mercer Wealth’s clients include sovereign wealth funds, family offices, and insurance companies among others.

From its office in Dubai, Mercer also looks after Africa, India and Turkey, where they also see opportunity for growth.

Wealth creation in Middle East and Africa (MEA) grew 8.5 per cent to $8.1 trillion last year from $7.5tn in 2015, higher than last year’s global average of 6 per cent and the second-highest growth in a region after Asia-Pacific which grew 9.9 per cent, according to consultancy Boston Consulting Group (BCG). In the region, where wealth grew just 1.9 per cent in 2015 compared with 2014, a pickup in oil prices has helped in wealth generation.

BCG is forecasting MEA wealth will rise to $12tn by 2021, growing at an annual average of 8 per cent.

Drivers of wealth generation in the region will be split evenly between new wealth creation and growth of performance of existing assets, according to BCG.

Another general trend in the region is clients’ looking for a comprehensive approach to investing, according to Mr AbuShaban.

“Institutional investors or some of the families are seeing a slowdown in the available capital they have to invest and in that sense they are looking at optimizing the way they manage their portfolios and making sure they are not investing haphazardly and different parts of their investment are working together,” said Mr AbuShaban.

Some clients also have a higher appetite for risk, given the low interest-rate environment that does not provide enough yield for some institutional investors. These clients are keen to invest in illiquid assets, such as private equity and infrastructure.

“What we have seen is a desire for higher returns in what has been a low-return environment specifically in various fixed income or bonds,” he said.

“In this environment, we have seen a de facto increase in the risk that clients are taking in things like illiquid investments, private equity investments, infrastructure and private debt, those kind of investments were higher illiquidity results in incrementally higher returns.”

The Abu Dhabi Investment Authority, one of the largest sovereign wealth funds, said in its 2016 report that has gradually increased its exposure in direct private equity and private credit transactions, mainly in Asian markets and especially in China and India. The authority’s private equity department focused on structured equities owing to “their defensive characteristics.”

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