Cash-strapped companies cut back on health insurance

With no legal requirement in Dubai to provide health coverage, many employers have treated it as a luxury and cut back, according to one doctor.

Health care in Dubai has been one of the casualties of the economic slowdown, according to Dr Bilal Hashim, a manager at the Lifeline Healthcare in Jebel Ali. With no legal requirement in the emirate to provide coverage, said Dr Hashim said, many employers have treated it as a luxury and cut back. He estimated that only five per cent of the 34,000 workers living in the free zone have health insurance or adequate access to health care.

"It is split into categories," he said. "All of the senior managers have health insurance but the middle managers and the people below them don't." The financial crisis has had a huge impact on the number of patients seeking treatment at the free medical camps that the hospital hosts in accommodation areas. The last one, last month, saw around 1,500 workers. "I would estimate that around 50 per cent of the construction companies in this area have either stopped their projects or reduced the numbers of labourers.

"There are definitely fewer companies offering insurance to their employees," Dr Hashim said. Before the financial crisis, the Jebel Ali Hospital Corporate Clinic hospital had a number of contracts with construction companies that would send their workers to be treated at a reduced rate, then pay the bill at the end of each month. As well as a reduction in the number of patients, the hospital also had problems with companies refusing to pay for their workers' treatment.

"A lot of the companies have put more restrictions on the employees and will only cover certain things," he said. "For example, some companies will not pay more than Dh20 for medication, or their workers have to get approval from there before having treatment." Dr Zarqa Taimur, who helps to organise free medical camps for the Pakistani community, estimates that half the 350 patients seen each month are uninsured.

"A trip to a doctor can cost someone Dh50," she said. "Plus the cost of investigations and medications. It can come to a minimum of Dh200. This is not feasible for someone who earns less than Dh800 a month." Some companies reimburse medical fees, but, according to Dr Taimur, there is usually a long list of treatments that are not covered. "We also see families with children. Sometimes an employer will give the husband insurance but will not cover the wife and children, so they are left in the lurch."

When Tony, 26, a Filipino designer, moved to Dubai two years ago he was told by his employer that any health insurance would have to come out of his salary of between Dh9,000 and Dh12,000 a month. That, he said, made affordability a concern, not only for him, but also for colleagues more likely to need health care. "I have colleagues who would like to have babies but are really bothered since they don't have health cards," he said.

He said he would be in favour of a mandatory healthcare scheme. With no requirement, he said, his company has been considering the issue for the past six months but has taken no action. Paul Martin, 48, a florist in Dubai who earns Dh3,000 a month, receives no health coverage from his employer. "Many people who earn much less can't afford the cost of health care in Dubai," he said, adding that the promised mandatory scheme would "really mean a lot" to low-paid workers.

However, the delay in implementing it has come as a relief to some companies that are still suffering from the downturn. "With the economic downturn there were a lot of debts, and with that the cash flow had gone," said Petra Harmer-Shrowder, the head of communications at the British Business Group. "So where were companies, even the bigger ones, to have found this money for their employees?" She said many firms had already cut costs - and jobs - to stay in business. Next year they would hope to be in a better position, but it was difficult to predict the "right time" for officials to introduce a healthcare scheme.

Samir Khosla, the vice chairman of Dynamic Staffing Services, which employs 800 staff, said companies that had not already budgeted for an increase in costs could still be in trouble next year. He warned that additional costs could "inhibit your ability to price competitively". Some owners of smaller businesses were also concerned about the cost. Mohammed Ali, 43, recently set up his own gym and is struggling to fund insurance for his staff.

"It takes a little bit more time than you think," he said. "Health care is very expensive."