Hospitals accused of recommending unnecessary tests



JEDDAH: IBRAHIM NAFFEE

Published — Monday 24 December 2012

Last update 24 December 2012 3:36 am

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Private hospitals in Saudi Arabia make exorbitant gains from medical insurance companies by subjecting patients to multiple unjustified and unnecessary medical tests and surgical procedures, a number of patients and hospital reviewers have said.
The criticism comes at a time when many private hospitals in Saudi Arabia are facing a torrent of accusations related to medical errors, some of which have caused deaths. An example is Erfan Hospital, which was closed temporarily by the health authorities in Jeddah following the death of a patient due to a medical error.
An often heard complaint is the increase in treatment costs at many private hospitals. According to medical insurance experts and members of the insurance committee at the Jeddah Chamber of Commerce and Industry (JCCI), medical insurance companies have specialist doctors who review hospital bills and follow up on patients’ files to verify how private hospitals adopt therapeutic procedures.
“Insurance companies give private hospitals limited powers with regard to treatment of patients. They cannot admit patients overnight or subject them to surgery without obtaining approval from the insurance company. This is done both to control the medical insurance bill as well as to protect the patient from becoming a victim of a hospital exploiting his or her medical insurance,” Ibrahim Ramel, an insurance consultant and former member of the JCCI’s insurance committee, said.
“If a private hospital misuses the powers granted to it by medical insurance companies, patients can complain to the health authorities,” Ramel said. He added that the higher costs of hospitals naturally reflected on the high cost of health insurance policies.
Insurance companies in the Kingdom are set to raise their health insurance policy by about 4 percent in 2013 due to the high costs of the health sector.
Beneficiaries of the insurance service consider this direction unjustified, as neither prices nor salaries have increased in the health sector.
In an interview with a local newspaper, Tal Nazer, CEO of Bupa Arabia for Cooperative Insurance, said: “The rising cost of hospitals, which has exceeded 20 percent, requires increasing the prices (of medical insurance policies). It is hard to keep the costs of insurance companies fixed.”

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