When trying to build a credible assessment of any healthcare system, a good first port of call is, of course, the facts and figures.
By considering everything from the quality of healthcare to the types of diseases the local population is most susceptible to, we are able to build a richer picture of where we stand, and even draw some fairly credible assumptions as to where we are heading.
With that in mind, in this article I wanted to take a look at seven key facts, the story behind them, and what the ramifications might be for the healthcare and health insurance system in the UAE – as well as for all of us who are a part of the system, and for all of those who are taken care of by the system.
1. Heart disease and cancer are the leading causes of death in the UAE
This should no longer come as a surprise, especially given that the picture around the world is very much the same. Heart disease and cancer are among the leading causes of death in most developed countries, including the United States, Canada, the United Kingdom and much of the rest of Europe.
What is still surprising to many, though, is that the two biggest killers are hugely affected by lifestyle choices. According to the World Health Organisation (WHO), at least a third of all cancer cases are preventable through healthier living. This figure is even higher when it comes to heart disease: America’s Mayo Clinic claims that some 80 per cent of cases are entirely avoidable.
As for what we can do to right this wrong, there is just one thing: prevention. Instead of waiting to get sick and treating the symptoms retrospectively, it is time for all of us – companies, healthcare professionals, insurers and individuals – to start taking a proactive approach. That means regular screening for early warning signs of disease, and far greater education on how our lifestyle choices directly impact our health.
2. There are approximately 260 types of genetic diseases within the Emirati population – the second highest rate in the world
The Arab world in general (and particularly the UAE and Oman), has a much higher rate of genetic disorders than the rest of the world. These conditions include sickle cell, cystic fibrosis and Down syndrome – where rates are in some cases twice as high as the global average. One of the main reasons behind this is widely thought to be consanguine, or inter-family marriage.
The good news is that health authorities in the UAE have recognised this and are making great strides in addressing the issue.
According to Dr Yousef Abdulrazzaq, a paediatrician and neurologist at the faculty of medicine and health sciences at the UAE University in Al Ain, there is only one way to tackle the problem – premarital screening. “Some of the diseases are very rare, which is why screening is crucial,” he says.
Clearly this is a very big challenge, and according to research the rates of genetic diseases continue to rise. No doubt the cultural factors at play must be factored in when considering a realistic and long-lasting solution to the issue.
3. The obesity rate in the UAE is double the world average
The recent findings in the Global Burden of Disease Study 2013, published by the University of Washington’s Institute for Health Metrics and Evaluation, reveal that over 66 per cent of men and 60 per cent of women in the UAE are overweight or obese.
It is perhaps the biggest indicator yet that the accepted lifestyle here in the UAE is taking a devastating toll on our health. Not only does overweight and obesity lead to a host of serious medical conditions for individuals, including heart disease, stroke and diabetes, it also takes a huge financial toll on both firms and the healthcare system as a whole.
Indeed, a 2013 study published in the American Journal of Health Promotion found that obese employees cost businesses an average of $4,000 more per year than those deemed to be ‘normal’ weight. Meanwhile, another study estimates the economic burden of obesity in the UAE to be somewhere in the region of $6bn a year.
As for what needs to be done to halt this toxic trend, again it comes down to prevention through education. Simply treating the devastating consequences of overweight and obesity once they arise is not enough.
Much more must be done to encourage healthy eating and frequent exercise in order to prevent excessive weight gain in the first place – and all with a realistic understanding of just how hard it is to eat healthy in the face of all the food temptations within arm’s reach at any given time.
4. Life expectancy in the UAE has risen from 52 in 1960 to 77 in 2015
The latest WHO figures put life expectancy at 77, the second highest in what is classified as the ‘Eastern Mediterranean region’ – lagging only behind Qatar in first place for the number of long-living people.
This demonstrates that huge progress has been made in the last 50 years. And in the last 15 years, in particular, the rate of the rise in life expectancy here has increased exponentially (much faster than in developed countries). It is a huge positive for the country.
For one thing, it highlights the huge medical advances that have been made. The direction of travel in terms of reducing the number of deaths through preventable and treatable diseases is something to shout about.
And that is not all. According to Dr Iman Al-Omar, consultant and head of gynaecology and obstetrics at NMC Royal Hospital, changing lifestyles have also played a part: “There are so many government programmes to live healthy and these play a big role. People are being encouraged not to smoke. There are gyms opening up and healthy eating is being given importance.”
It only goes to show that a concerted and progressive effort to force change can pay dividends. This could be replicated when it comes to things like tackling obesity and other preventable conditions.
Of course, we have to also be honest in acknowledging that a big factor in the longer lifespan issue is tied to the fact that those medicines and medical procedures are keeping people with illness (most of the time caused by poor lifestyle) alive much longer. So to be clear, while those making healthier lifestyle choice are playing their part, it is likely still a small part in the bigger picture.
Finally, also here it is worth adding a cautionary note. With longer lives comes an increase in end-of-life diseases – like cancer and Alzheimer’s – cases of which are predicted to soar by up to 600 per cent by 2030 here in the UAE due to even higher life expectancies. Therefore, the health system must start preparing for this extra strain on resources now with better forecasting and planning.
5. There are just 1.5 doctors for every 1,000 people in the UAE
The doctor-to-civilian ratio is still low in comparison to other developed nations across the world, and only slightly above the WHO prescribed limit of 1:1000. The US, for example, boasts 2.45 doctors per thousand people. Meanwhile the UK – which has fewer doctors per person than almost all other European countries – still outdoes the UAE with 2.71 per thousand people.
Clearly, this shortage has to addressed. Particularly in light of a recent Health Authority Abu Dhabi (HAAD) publication forecasting the need for at least 4,800 doctors and 13,000 new nurses by 2020 in order to cope with increasing pressures on the country’s healthcare system.
The good news, however, is that ambitious plans are already afoot to help meet this demand. Last year, the Dubai Health Authority (DHA) announced its plans to push ahead with the construction of three new medical colleges and five nursing schools so as to bring the emirate’s doctor-to-patient ratio in line with the rest of the world.
6. The UAE spends $1,200 per person on healthcare – putting it in the top 20 countries for healthcare spending per capita
The healthcare spend per person is commendably high in comparison to much of the rest of the world. However, this figure alone does not tell us whether this money is being well spent. Without that information, it is difficult to know what to take from this piece of information.
On the one hand, a relatively high spend per person can have a ripple effect throughout the entire system – improving facilities, training and retaining expertise as well as bettering the overall patient experience. On the other hand, such figures do not account for waste or fraud – which is thought to cost the UAE healthcare system around $1bn per year.
However, if we look at this figure in tandem with the WHO evaluation that the UAE healthcare system is the 27th best in the world (although to be fair, this ranking was last done in 2000 and not done again since due the “complexity” of the task), we see some interesting things. Mainly, while countries like the US and Canada spend more per person, the UAE was considerably further up in the rankings.
Obviously we have to take all such figures with a grain of salt, but spending wisely is key here, in particular to ensure that the trend remains the same despite the pressures from a rapidly growing population – not to mention the increase in lifestyle-related diseases and current shortage of doctors.
7. There are over 60 approved insurance companies and 120 licensed insurance brokers practising in the UAE
One thing that the UAE certainly does not have a shortage of is insurance companies and brokers, which at first glance may not seem like such a bad thing. However, take a deeper look and we can see that many of these companies are struggling – which spells bad news for the consumer and the healthcare system as a whole.
In 2015, the Abu Dhabi Securities Exchange and Dubai Financial Market (DFM) reported a market loss for the insurance industry of approximately Dhs106m (or $29m). What’s more, of the insurers listed by the DFM, 20 reported worse figures than in 2014. And 13 posted a net loss for 2015.
This troublesome trend looks set to continue.
Without a doubt, the reason behind this is an overcrowded marketplace. Allowing 60 insurers to operate in a relatively small country is simply not viable.
While competition may seem like good news for the consumer, it often is not. With so many companies vying for market share, many firms take policies at a loss just to keep business. Predictably, this results in an unstable insurance market.
Added to this, greater competition usually leads to a greater variation in price. This has the potential to lull businesses and consumers into believing they are getting more ‘bang for their buck’. This is almost always untrue. In most cases, where prices are reduced so too is the level of cover being offered.
To help combat this, companies and individuals must change their approach to procuring healthcare. Remember this is not simply about finding someone to foot the bill when things go wrong, but rather working with an organisation to reduce the risk of having to make a claim – while achieving peace of mind that robust policies are in place should you need to.
The road ahead
As we have learned, there are some great positives to cheer about and some significant negatives to improve upon in the current healthcare system. But no doubt the future for the UAE healthcare market and its impact on all residents can be very bright if large companies and governments and health authorities match one another in their ambitions and efforts.
One recurring theme is that better education is needed in relation to lifestyle diseases. And there is much that all key players can do here – be it through wellness programmes or closer ties with medical professionals in order to ensure we are all receiving the correct advice.
To be clear, all of us – that includes businesses, insurers, healthcare providers, the government, and individuals – must work together to ensure we confront any healthcare challenges we face head on and with utmost honesty with respect to what will actually lead to sustainable solutions.
Only then can the UAE improve upon its already impressive standing in this field. Let us make a collective effort and push things forward. The alternative to not doing so is simply not an option.
Stephen Maclaren is the head of Regional Sales Employee Benefits at Al Futtaim Willis