CHANGING THE GAME

Lebanon 2012 | HEALTH & EDUCATION | REVIEW: HEALTH

Known for its quality throughout the region, Lebanon's healthcare sector is beginning to throw off the shackles of the past and provide a more balanced package of care.


The healthcare sector in Lebanon is among the best in the region, with overhaul in the sector getting the private sector back on track after a difficult period. Leading the way in regional indicators, the sector also has a strong base on which to grow.

Private care is considered to be of a higher quality in Lebanon, and the private sector boasts the lion's share of the country's 177 hospitals—making a ratio of four beds per 1,000 people—and over 11,000 physicians. The Ministry of Health regulates the sector, and private institutions receive accreditation every two years. Prices, however, remain high, and the inability of the government to foot the bill creates the largest challenge in the sector. “We believe access to health care is the right of the people, and that hospitals must work to accommodate everyone," Dr. Nazih Gharios, President and General Manager of Mount Lebanon Hospital, told TBY.

While total healthcare expenditure is around 9% of GDP, total healthcare expenditure per capita was recorded at around $1,000 in 2010, way above the regional average of under $200. In 2009, according to the World Health Organization (WHO), the Ministry of Health was assigned 12.4% of the total government budget.

The country is also carving out a name for itself internationally, with Lebanon an ever more attractive destination for health tourists and those looking to have some work done at European standards. The health tourism sector is also expected to grow by around 30% in 2011, according to the Agency for Investment and Development in Lebanon (IDAL).

THE NUMBERS

Leading the region in terms of health indicators, Lebanon's status as a beacon of medical professionalism is well founded. The average life expectancy in the country is 72 years, a full eight years higher than the regional average. Adult mortality per 1,000 people (aged 15-59) stands at 124 in Lebanon, and 188 regionally. Furthermore, the under-five mortality rate per 1,000 live births is 12, and 72 in the region. Infectious disease ratios are also low, with only one case of HIV per 1,000 people (adults aged 15-59), and only 20 cases of tuberculosis per 100,000 people, as opposed to 174 in the region and a global average of 201.

Lebanon, however, excels in the number and quality of its physicians. “Lebanon boasts excellent doctors that are trained in the best universities and hospitals worldwide," Dr. Nazih Gharios explained to TBY. Compared to the region, there are 35.4 doctors per 1,000 people in Lebanon, and only 11 in the region, according to statistics from the WHO. Lebanon also outnumbers the regional average number of nurses, at 22.3 per 1,000 people versus 15.4.

PRIVATE vs. PUBLIC

With most healthcare providers in private hands, the government has struggled to get the sector back on track following the prolonged civil war, during which private institutions footed much of the bill for public health care. Today, the sector is undergoing restructuring aimed at improving access to the top-quality health care associated with private hospitals in Lebanon.

“The healthcare sector is passing through a critical period. Financial issues are posing challenges as returns on investment are slow," Dr. Nazih Gharios told TBY. Wassim Wazzan, President of the Rafik Hariri University Hospital, remains upbeat, however, telling TBY, “We have one of the best systems in the world. The Ministry of Health covers around 50% of the population, and people have access to medical services without waiting periods."

With an aim to provide reasonably-priced health care to the population, Rafik Hariri University Hospital boasts 400 beds, and around 35% of its patients are covered by public funds, again bridging the gap between the public and private sector following the cessation of a similar system of public-private transfer in 2006.

INSURANCE

There are two main kinds of insurance available in Lebanon: publicly provided plans from the National Social Security Fund (NSSF), the Civil Servants' Cooperatives or municipal government plans, and plans of the security and armed forces; and privately held insurance, for those who are employed, self employed, or syndicated. The NSSF covers 40% of the population—around 1.3 million people. “Approximately 20% of people are self-payers, meaning they are without health insurance," Dr. Nazih Gharios told TBY.

HEALTH TOURISM & AESTHETIC SURGERY

As medical tourism becomes more prevalent—an estimated 600,000 people per year travel abroad for procedures according to Deloitte—Lebanon is getting its fair share. Procedures offered range from cosmetic surgery to organ transplantation, and well-trained doctors, moderate prices, and relatively liberal laws have worked to attract foreign customers. The improvement of facilities across the GCC, however, has meant Lebanon is struggling to attract the amount of Arab medical tourists it has in the past. The aesthetic surgery sector is also getting a share of international clients looking to take advantage of the country's well-trained personnel and moderately cheap prices. “The price is certainly a factor," Roger El Khoury, Plastic & Aesthetic Surgery Medical Director at Beirut Beauty Clinic, told TBY, adding that the most popular procedures for both foreign and domestic clients are “hair implants, liposuction, and rhinoplasty" for men, whereas for women “the most popular non-surgical procedure is Botox, and for surgical it is the nose first and the chest second."

With estimates for growth to continue at 30% per year, medical tourism as well as the aesthetic surgery sector are set to develop in tandem with the general healthcare sector and provide top-quality medical coverage in a more sustainable way.