Public sector employees still await the implementation of compulsory health insurance which was scheduled to be put into action at the beginning of 2008. With a year and several months gone by since then, statements from health insurance workers suggest that the time is still not right as the infrastructure of the health sector is still lacking and insurance companies do not yet have the experience required. All of which only serves to exacerbate the frustrations of workers in the public sector. “I and others like me working in the public sector are still waiting for health insurance for public sector employees, which would go a long way to easing our sufferings,” says Fawaz Salama, a district administrator in Jeddah receiving treatment at King Fahd Hospital. “Whenever anyone in our family falls ill we suffer,” he continues. “I have six children, and despite the availability of treatment for me and my family, sometimes we find there are long waits between appointments at government hospitals or we find there is no specialist doctor at health centers, and so we are forced to go to private hospitals which cost a lot of money.” Saleh Muhammad Al-Ghamdi is still wheelchair-bound following medical tests in a private clinic in Jeddah “I have heard a lot about the health insurance plan, but personally I wouldn't benefit from it because I'm already retired, so I'm not included in the plan,” Al-Ghamdi says. “But I hope that will change and that parents are listed as dependents so they can get treatment.” Mousa Abdullah, a Ministry of Education employee in Jeddah, said teachers stood to gain the most, with their number exceeding 400,000. “It will relieve them of a huge financial burden,” he says. Muhammad Qadah is the owner of a private school. “As part of the private sector it is compulsory for us to provide health insurance to every teacher working at the school. That includes full insurance for the teacher and his family. The school's administrative formalities are not carried out in government departments, such as the Passports Department and Labor Office, unless we can present proof that all employees have health insurance cover. This has been highly beneficial and shows concern for staff. Health insurance enables them to lead stable lives with peace of mind.” Balsam plan “We are still waiting for the introduction of compulsory health insurance for Saudi nationals, or the Balsam Project, as it is called,” says Khalid Al-Marghalani, a Ministry of Health spokesman. “The delay is due to the lack of a feasibility study to give us the go-ahead. When the Ministry of Health has looked at the Cooperative Health Insurance Council's study, the Ministry of Finance will introduce the project through the Health Insurance Fund chaired by the Minister of Finance, while the Minister of Health will supervise the service provided to employees in the public sector. Employees will be covered by policies from approved insurance companies.” Abdel Ilah Sa'aty, an insurance expert, says the health insurance law was enacted in 1999 to provide health care for all expatriates in the Kingdom. It stated that its introduction would follow a decision from the Council of Ministers. On October 22, 2002, the Council of Ministers issued a decision to introduce health insurance for Saudis working in the private sector. Then there remained the final stage, to introduce it for public sector workers, both Saudis and expatriates, according to Article 10 of the Health Insurance Law which stipulates that employers are responsible for providing cooperative health insurance for their employees.” Lack of facilities, experience “However,” Sa'aty says, “current facilities mean that the plan cannot be introduced for the 1.5 million domestic workers due to poor infrastructure in the health service and a lack of experience in the insurance sector, which is a relatively new field in the Kingdom.The sheer number of expatriates coming in cannot be catered for. There is a beds crisis in the private health sector and a shortage of health services.” “The private health sector has not kept pace with the considerable growth of population resulting in a greater demand than supply,” Sa'aty continues. “So before the plan is put into action we have to first evaluate the current health insurance system for private sector expatriate and Saudi workers and then we will be able to determine what should be done next.” “I think there is a need to increase the number of insurance companies from 25 to 35 and merge some of the smaller companies. We still also need to complete the licensing process for some companies whose applications are still under consideration.” Ali Al-Sabhain, Executive President of Tawuniya Insurance Company, agrees. “There needs to be an expansion of facilities to accommodate the large numbers of patients. Certain issues need to be clarified, such as who will cover the cost of treatment.” “The state has provided citizens and residents with medical care, and with the introduction of health insurance the private sector has become responsible for providing medical care to its workers through insurance companies,” says Mohammed Al-Shareef, head of the Shoura Council's Health and Environment Committee. “We are currently working to introduce this into the public sector and when the time is right it will happen without delay. This country is leading the way in the field of health. The Shoura Council still hasn't looked into public sector health insurance as we study issues as they come to the Council. But the health service is currently available to citizens, and it is a service of a high standard, and if there is a need for specific types of treatment to be sought abroad then that is also carried out.” Dr. Abdullah Al-Muqbil, education ministry undersecretary, says that insurance plans specifically for teachers had been proposed and rejected. “The ministry granted the education administration the authority to introduce medical insurance for its employees and presented a new plan for health insurance for teachers. The health ministry's response was that there was a plan for health insurance for all citizens, the “Balsam” plan, in which teachers would be included,” Al
