Everyone suffers when unscrupulous professionals flout the system for their own ends – such as the dentists depicted in our story yesterday who juggle the claims system to perform work that would not usually be covered. The insurance companies obviously suffer because costs are higher than they should be, and it means all of us pay a price because rising prices means coverage gets cut or more bureaucratic hurdles are introduced to minimise fraud. Ultimately it has an inhibiting effect on the economy overall if employers are reluctant to take on more staff because of the cost of providing health insurance.
In an ideal world, medical professionals should face as few impediments as possible in performing their roles, and particularly when a patient is in acute pain. But we don’t live in an ideal world, which is why a balance needs to be struck between ensuring those who are suffering are treated as quickly as possible and making sure the system isn’t being abused. For the most part, this balance has been struck – correctly – on prioritising treatment over bureaucracy.
But that also allows scams to propagate. As we reported, many dentists will obtain approval in advance for procedures that are covered by insurance, such as fillings, but will then use the money to pay for cosmetic treatments that are not. This kind of arrangement is described as both systematic and common but because both the dentist and the patient benefit from this deal, neither side is likely to draw attention to it. The overall effect, however, is to cause the cost of dental cover to rise markedly.
An oversupply of dentists would normally drive prices down but is actually worsening the problem, because even honest practitioners feel compelled to fiddle the claims system to make them competitive with others vying for business. With 2,500 healthcare facilities in Dubai and a new one being approved every 36 hours, this problem is unlikely to go away soon.
The UAE is already in the top 20 countries for the cost of health care, with Anglo Arabian Healthcare estimating the annual cost per person at Dh4,408. It is why the President, Sheikh Khalifa, announced a decree last month on this subject, requiring all forms of medical professionals to “provide patients with necessary care without using their need to achieve illicit or illegal profit”. The implications go far beyond just the provision of unwarranted dental care, which is why this misuse has to be stamped out.
