I have spent much of the last four years working in the Middle East as an interim CIO and executive project director at two different hospitals. I have seen the healthcare systems of two different countries from both a business perspective and a patient perspective. Since I was primarily in the UAE for most of that time, I would like to point out some of the notable differences between what I experienced at home versus there.

By way of background, the first hospital in the UAE was started in 1960. It was the hospital where I spent my time while working there. It was a mission hospital, as many of the first hospitals in the Middle East are. Though oil had already been discovered several years prior, the revenue from that discovery had not yet been used to improve the lives of the local citizens. They were still living in tents, and camels were their primary mode of transportation. The population of the UAE at that time was about 131,000 people.

Fast-forward to today, when the population is about 11 million, and the country is known more for its wealth than for anything else. It should also be noted that only about 20% of the population are native Emiratis, who benefit greatly from government programs, especially healthcare. All ex-pats are required to have insurance and all businesses are required to provide that to their employees.

The first major notable difference is the health care model. While the US has a predominantly private system, the system in the UAE is almost entirely governmental. In the US, the government owns about 20% of the hospitals, but in the UAE, that is flipped, with the government owning about 70% of the hospitals. Government control of health care is the primary difference between our system and theirs. The UAE requires all health insurance payments to be made through the government and the government has a very complex payment model that determines payment based on government versus private, complexity of care and negotiated rates with the insurers. However, it is well known that the speed of that payment is directly related to the organization’s relationship with the government entities which are led by people appointed by the royal family.

From a patient perspective, I found the quality of care to be comparable to what I receive here at home. The most noticeable thing to me as a patient was the cost. Prescription prices are very low. I had a clinical experience requiring me to visit my local emergency room. I had not yet acquired insurance and yet the total charges for that visit were approximately 1/3 of what it would have cost here in the US.

Another notable difference was access to healthcare. While we continue to struggle with access in the US, it is a nonissue in the UAE. As a result, the UAE has higher life expectancies (79 years vs. 76 years), lower infant mortality rates (4.9 vs. 5.4 per 1,000 live births), lower obesity rates (30% vs. 42%), and much lower maternal mortality rates (3 vs. 17.4 per 100,000 live births). They were also much more effective in addressing the COVID pandemic.

However, one of the most significant areas that the UAE struggles with is mental health, And that is primarily due to the culture itself. It is not discussed or recognized privately or publicly, and treatment options are scarce.

My opinion on this may be controversial. Still, I’ve concluded that more government control of healthcare in the US would benefit its citizens, especially in access and cost. There is a trade-off in this regard, and our government itself is a very different model than in the UAE. But more needs to be done to ensure that everyone has access and an opportunity for good health here at home.