As every year, by the end of March, which marks the conclusion of the first quarter, major unions renew their annual health insurance contracts with the companies they deal with. Among these significant unions are those for lawyers and engineers, which consist of tens of thousands of members along with their families and relatives wishing to benefit from the discounts granted to large groups.
This year, the situation is clear regarding payments in fresh cash dollars or the equivalent at the exchange rate in unofficial trading markets. Many have complained, especially those insured with the private insurance company of the lawyers' union, that they have been unable to perform medical and laboratory tests outside hospitals under the insurance contract for 2021. This is due to the refusal of most medical centers and laboratories to accept the insurance policies from the union, stemming from disputes over tariff calculations between the union's insurance company and the centers and laboratories.
The dispute arises because the insurance premium was initially paid in "Lebanese dollars," known as "lollar," which had a set rate of 3,900 Lebanese pounds before being raised in the latter part of last year to 8,000 pounds. However, what stands out in the current contracts of the two major unions and others is the influx of new family members seeking insurance, including parents and siblings, who previously relied solely on the Lebanese official health insurance and state employees' cooperatives.
However, the "first era has shifted" after many hospitals refused to accept patients relying on health coverage through those institutions, demanding that insured individuals bear the significant financial differences. Only chronic illnesses such as cancer and kidney dialysis still receive health coverage of up to 90% through the National Social Security Fund and the employees’ cooperative (for current and retired workers). Meanwhile, pricing varies in other cases, as "the exchange rate for chronic illness patients is set at 1,500 pounds, while the rate for other patients is no less than 23,000 pounds," according to an employee in the admissions office of a well-known medical center in Beirut, who insisted on maintaining anonymity for fear of professional repercussions.
In the same center, a patient completed a monthly session for cancer treatment, which was almost entirely covered, with her family only having to pay a difference of less than 100,000 Lebanese pounds. However, the patient required hospitalization after suffering from hip pain, which turned out to be unrelated to cancer. Her family was required to provide a financial advance of about 1.5 million pounds for emergency room admission and then pay for a first-class room while covering the insurance difference due to a lack of beds covered by insurance in the second class. The prepaid costs reached 35 million pounds for two nights, including medical tests.
The reality is that other hospitals do not adhere to the official coverage for chronic diseases and charge additional out-of-pocket expenses under the pretext of certain expensive medications being unavailable. They ask patients' families to secure these medications, leading them to struggle to obtain them at high prices without government support.
These issues have led to an unprecedented influx of new insured individuals seeking private insurance companies. In the past, these companies refused to accept elderly individuals and required those over the age of 40 to undergo medical tests while excluding those with high blood pressure from coverage for such cases.
Now, circumstances have changed, and the search for cash dollars from insurance companies is parallel to the quest for healthcare from patients. This situation is available only to those who can afford to pay. Meanwhile, those struggling to meet their daily needs and cover monthly bills for basic necessities feel intimidated at the hospital doors and pray to remain free from illness, as they lack the financial capability to confront a health crisis before addressing their healthcare needs!
