To Insure or Not To Insure – Lessons from Abu Dhabi

2 Agenda 2 Rationale Regional Choices Possible Implications for Iraq

3 Why mandatory health insurance Protect against risk of financial ruin and increase access to services Shift financing burden from government to employers/employees Increase financial/clinical transparency and increase efficiency through better incentives Make people happy through more choice (public and private) and increase customer responsiveness of providers (money follows patients) Risks?

4 Agenda 4 Rationale Regional Choices Possible Implications for Iraq

Regional Design Choices Abu DhabiSaudi ArabiaQatar (planned) Dubai (as-is) Mandate for all expatriates* yesno? Insurance for locals with choice of private providers yesnoyes(no) Modern payment system** yesnoyes(yes) Subsidy for low- earning individuals yesno? *including domestic staff **including mandatory electronic exchange of all information and partial risk transfer to providers (e.g., DRGs)

6 Agenda 6 Rationale Regional Choices Possible Implications for Iraq

7 Challenges Does Iraq suffer from lack of meaningful access for a significant part of the population? Does Iraq suffer from poor data quality (clinical and financial) and lack of accountability? Does Iraq suffer from a (perceived) lack of responsiveness of its generously financed public sector? Does Iraq want to encourage private sector investments into health care even if it comes at a higher cost? Does Iraq need to respond to increasing pressure to share the resource wealth through social programs that deliver tangible value to individuals even if it comes at an increased cost? Can Iraq manage the complexity inherent in the creation of a modern payment system (including the creation of an able regulator)? If you insure, know why