Socialised medicine vs Free Market
I am trying to figure out which category to include the current UAE health care system in. It would seem that we have three different models running at once. Like most other countries, we’ve always had a private and a government sponsored health care. Ten years ago, everyone got free treatment in government hospitals. This presented a certain problem because with no taxation, an expanding population and shrinking local percentage (currently only 18% of 4 million people are locals), the government was spending more and more federal money to treat foreigners. It does not take a lot of math to figure out they could not go on doing this indefinitely and that is why things shifted to an insurance model. While this sounds great in principle, a closer look shows that basicaly, we moved from socialised medicine to a government monopoly on primary, secondary and tertiary care. Yes, private hospitals still operate but there is no incentive for government staff to compete with them. Salaried doctors have no personal gain from providing competetive service. Across the board salary raise is neither practical nor sustainable in the long run.
In summary, foreigners have the option of free market or the government monopoly. Locals have both of these options in addition to socialised medicine model available to them. Single payer model, which I have seen to work very well in the primary service in the UK is not really available to anyone.
Afterthought (Update):
Its probably easier to think of the new arrangment as Free Market in addition to Socialized Medicine for locals and free market only for forigners where the government attempts to compete with private hospitals for business. Same problem applies though: staff in government hospitals will not have any personal gain from providing competitive service and across-the-board salary raises are unsustainable.
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