400 Experts put an ideal study for the application of medical insurance for citizens, and the development of the health system under the title (project Balsam) where the team made use of a health management expert & health insurance Professor Reda bin Mohammed Khalil, and several academic and an executive figures in the health, economics and social sciences fields, representing the Ministries of Economy and Planning , the civil service, financial, health, the Shura Council, the Saudi Commission for Health Specialties, universities, media and municipal councils, and some businessmen and investors in the health sector, commercial and industrial rooms, and insurance companies.
The study, which lasted a whole year, included seven main classes, showed that there are a number of fundamental principles and reforms that the development of the health system strategy will start from, in the forefront of them is the continuation of coverage for the treatment of citizens at the expense of the state without loading citizen any costs for it, as expressed by the Basic Law of Governance. And that there are additional sources of financing of health services provided to citizens free of charge next to the public treasury of the state, as expressed by the new health system in the tenth article.
One of the recommendations is to support primary health care centers and focus on making them responsible for the basic health needs of the citizens, in addition to improving its performance and support them by necessary material and financial possibilities, and emphasize the role of family physicians working in primary health care centers. And the Ministry of Health focuses on its key role in the planning, organization and supervision, coordination and monitoring the quality and performance of services and work on the development and upgrading, as well as its key role in operating the primary health care centers and programs of preventive medicine and the preservation of public health and the creation of a fair formula for the distribution of health resources to all regions of the Kingdom
Recommendations required for any program of reform to be accompanied by a remarkable shift in the health service received by the citizen beside variety of options level to the citizen. And the need for separation between funder of service & its provider & purchasers and the observer of its performance so as to ensure the highest level of performance and quality, and activating the partnership between the public sector and private options. And the granting of an independent budgets and broad powers to the directorates of Health Affairs to oversee quality control and improve performance in the light of national benchmarks. And that the proposed model for the development should be easy, simple , uncomplicated and easy to understand . And apply its implementation does not require a large financial burden. And that the State is able to make the shift from spending on health service to spending on the beneficiary. And the need for community participation in the implementation of health plans and programs
The study showed that the idea of the proposed model was based on six key components for the development of the health system:
-Develop primary health care services, both preventive and curative health as a basic rule of the health pyramid, and emphasize the role of the family doctor
-Establishment of a public institution for hospitals in the Kingdom and become the ownership of all Ministry of Health hospitals and has legal personality and independent financial disclosure,
Establishment of a national fund for health services, non-profit,-
-Adoption principle of granting separate budgets for General Directorates of Health Affairs in various regions of the Kingdom, to achieve the flexibility and decentralization of health programs in each area
-Establishment of the Council of Health Services for each region to develope appropriate regulation between different levels of health services and the National Fund for health services,
-Elaboration of coordination and integration between all concerned authorities to provide health services in the region policy.
The study showed the importance of the idea of the National Fund for health services, which represents a big leap, and the most important pros that it enables the State to shift from spending on the production of health service to the spending on the beneficiary and thus achieve the efficiency of spending on health and increase yields resulting from spending, as well as the achievement of social justice in the distribution of health spending and provide treatment for beneficiaries with the same quality..
The study recommended the application of the proposed program of reform and development on three main stages ..
The first is of three years during which the establishment of a unified and integrated health information system, create a network linking all sectors and sanitation, unite medical ID of citizens, creating an effective centralized system to monitor the performance and quality, impose penalties on violators of enterprises and individuals, creating a private additional funds to provide insurance for pilgrims or otherwise, and not to drain the resources of citizens, also the Ministry of Health to get rid of non-medical services such as transfer of ownership of the health institutes and colleges to one of the educational institutions, and the provision of a national organization of emergency.
Also one of the recommendations is redirection and distribution to be a greater focus on health issues and disease prevention, as well as training and continuing medical education and research, besides to development of legislation and executive mechanisms and the steps required to implement the reforms described above are and to allocate the amount of money required to do so.
The second phase is of three years and during which begin the work of public institution for hospitals and begin to perform their tasks. As well as the National Fund for Health Services. And to continue the development of primary health care.
And begin the subsequent stages of the end of the second phase during which to consider the involvement of affluent citizens to contribute to the payment of an annual premium to fund additional services, in return for the fund to pay the full cost of services provided to them, and work to strengthen and develop the positive aspects of the models that have been applied in second stage, monitoring developments in health reform that could be successful in the experiences of other countries close to the Saudi experience and can be used in the health system of the kingdom to become an advanced and up to the ultimate goals of the reform and the most important of them is the ability of the individual to choose of facilities where he receive his treatment at the highest level of quality
The study, which lasted a whole year, included seven main classes, showed that there are a number of fundamental principles and reforms that the development of the health system strategy will start from, in the forefront of them is the continuation of coverage for the treatment of citizens at the expense of the state without loading citizen any costs for it, as expressed by the Basic Law of Governance. And that there are additional sources of financing of health services provided to citizens free of charge next to the public treasury of the state, as expressed by the new health system in the tenth article.
One of the recommendations is to support primary health care centers and focus on making them responsible for the basic health needs of the citizens, in addition to improving its performance and support them by necessary material and financial possibilities, and emphasize the role of family physicians working in primary health care centers. And the Ministry of Health focuses on its key role in the planning, organization and supervision, coordination and monitoring the quality and performance of services and work on the development and upgrading, as well as its key role in operating the primary health care centers and programs of preventive medicine and the preservation of public health and the creation of a fair formula for the distribution of health resources to all regions of the Kingdom
Recommendations required for any program of reform to be accompanied by a remarkable shift in the health service received by the citizen beside variety of options level to the citizen. And the need for separation between funder of service & its provider & purchasers and the observer of its performance so as to ensure the highest level of performance and quality, and activating the partnership between the public sector and private options. And the granting of an independent budgets and broad powers to the directorates of Health Affairs to oversee quality control and improve performance in the light of national benchmarks. And that the proposed model for the development should be easy, simple , uncomplicated and easy to understand . And apply its implementation does not require a large financial burden. And that the State is able to make the shift from spending on health service to spending on the beneficiary. And the need for community participation in the implementation of health plans and programs
The study showed that the idea of the proposed model was based on six key components for the development of the health system:
-Develop primary health care services, both preventive and curative health as a basic rule of the health pyramid, and emphasize the role of the family doctor
-Establishment of a public institution for hospitals in the Kingdom and become the ownership of all Ministry of Health hospitals and has legal personality and independent financial disclosure,
Establishment of a national fund for health services, non-profit,-
-Adoption principle of granting separate budgets for General Directorates of Health Affairs in various regions of the Kingdom, to achieve the flexibility and decentralization of health programs in each area
-Establishment of the Council of Health Services for each region to develope appropriate regulation between different levels of health services and the National Fund for health services,
-Elaboration of coordination and integration between all concerned authorities to provide health services in the region policy.
The study showed the importance of the idea of the National Fund for health services, which represents a big leap, and the most important pros that it enables the State to shift from spending on the production of health service to the spending on the beneficiary and thus achieve the efficiency of spending on health and increase yields resulting from spending, as well as the achievement of social justice in the distribution of health spending and provide treatment for beneficiaries with the same quality..
The study recommended the application of the proposed program of reform and development on three main stages ..
The first is of three years during which the establishment of a unified and integrated health information system, create a network linking all sectors and sanitation, unite medical ID of citizens, creating an effective centralized system to monitor the performance and quality, impose penalties on violators of enterprises and individuals, creating a private additional funds to provide insurance for pilgrims or otherwise, and not to drain the resources of citizens, also the Ministry of Health to get rid of non-medical services such as transfer of ownership of the health institutes and colleges to one of the educational institutions, and the provision of a national organization of emergency.
Also one of the recommendations is redirection and distribution to be a greater focus on health issues and disease prevention, as well as training and continuing medical education and research, besides to development of legislation and executive mechanisms and the steps required to implement the reforms described above are and to allocate the amount of money required to do so.
The second phase is of three years and during which begin the work of public institution for hospitals and begin to perform their tasks. As well as the National Fund for Health Services. And to continue the development of primary health care.
And begin the subsequent stages of the end of the second phase during which to consider the involvement of affluent citizens to contribute to the payment of an annual premium to fund additional services, in return for the fund to pay the full cost of services provided to them, and work to strengthen and develop the positive aspects of the models that have been applied in second stage, monitoring developments in health reform that could be successful in the experiences of other countries close to the Saudi experience and can be used in the health system of the kingdom to become an advanced and up to the ultimate goals of the reform and the most important of them is the ability of the individual to choose of facilities where he receive his treatment at the highest level of quality
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