The limits of health cover

Hospitals must evaluate how much help they can provide underinsured patients in need

The emergency room of Tawam Hospital in Al Ain. Andrew Henderson / The National

The story of a pregnant woman who was turned away by two hospitals in Sharjah and Ajman because she could not pay for a Caesarean delivery, nor was covered by medical insurance, is a sober reminder of the potential pitfalls of our healthcare system. Thankfully, the woman ended up receiving the care that she needed, but the issue of underinsured patients remains.

Around the world, many people are not familiar with the extent of their health cover. Often, people become aware of the limits of their cover only when they are in need of a specific procedure. The same is true closer to home.

We are blessed with a decent healthcare sector and most residents have some form of health insurance. But problems sometimes arise with the limits of care and, especially, for those residents who find themselves between jobs and uninsured.

Health care operators would do well to heed the example of the Oasis Hospital in Al Ain. The hospital, which was founded in 1960, believes everyone seeking treatment “deserves to be taken care of in the best way possible”.

Trey Hulsey, the hospital’s president, says that the hospital’s primary concern is caring for the patient rather than trying to figure out how much to bill them. In reality, this means the Oasis will often treat patients who lack adequate insurance and will sometimes cover the greater share of the patient’s costs. To address this issue, the hospital will soon begin raising funds to plug this gap.

The question now is: should other hospitals follow the Oasis example?

Certainly there appears to be some merit in having funds set aside to treat underinsured or uninsured patients. Private hospitals may argue they are commercial entities, but equally no healthcare provider would actively want to turn away a patient in urgent need. With some pragmatic discussion and, perhaps, a means-tested fund for the underinsured to turn to, the imperatives of care and cost can both be answered.