2023-06-11 17:00:00
Today (Sunday), the General Authority for Competition issued a general summary of the study of the structure of the health insurance sector and the impact of the behavior of the establishments operating in it on competition, based on its tasks and specializations in studying and evaluating different markets and sectors.
The Authority stated that although the health system is regulated by several entities, the pricing of medical services provided by providers in the private sector – including negotiation mechanisms, pricing and discounts – is not comprehensively regulated by any of the regulators.
And she indicated that the health insurance sector in the Kingdom is characterized by its following the fee-for-service model, as 97% of the policies sold are collective policies designed for clients, from large, small and medium companies, and they are highly customizable, and vary greatly in their prices depending on a number of inputs and factors. Product design.
She indicated that the health care services system was designed to provide ease of access and quality at a relatively reasonable cost, but over-diagnosis, over-referral and over-treatment are common risk factors for the system.
A number of government agencies, such as the Ministry of Health, the Health Insurance Council and the Saudi Health Council, participated in the study, which concluded a set of results, most notably that the level of concentration in private health insurance is high compared to the group of reference countries.
The study recommended improving regulations, claims exchange processes between insurance companies, and reducing barriers to entry and expansion in the sector.
The authority is preparing pivotal studies of market structures and anti-competitive monopolistic practices in various sectors. This is in order to show the current situation of the sector and the conditions of competition.
The study aims to analyze and limit the challenges facing effective competition in the health insurance sector, in comparison with the leading international best practices in the field in order to draw lessons learned from them.
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