Interview

Madison Johnson interviews Leslie Todd about her experience with the healthcare system in Dubai, UAE. The healthcare system in Dubai is a private, multi-tiered system. Expatriates working for specific companies receive healthcare insurance based on their employment contract. Different tiers of insurance coverage exist, with more expensive plans offering more flexibility in choosing healthcare providers. Emiratis receive government-subsidized healthcare. Leslie's insurance allowed her to use private hospitals and clinics in both the UAE and the US. Access to doctors and specialists was easy with good insurance, but domestic workers had to wait at clinics for appointments. Leslie liked the accessibility of healthcare in the UAE compared to the US. She mentioned that the US could potentially improve its system by recruiting more healthcare workers from other countries. Cultural and communication barriers sometimes existed due to the diverse backgrounds of healthcare professionals in the U Hello, everyone. Hi, I'm Madison Johnson and I'm here today with my guest to talk about her experience with the health care system in Dubai in the United Arab Emirates. Would you mind introducing yourself really quick? Hi, my name is Leslie Todd, and I lived in the United Arab Emirates for approximately 20 years. So I've had over the course of 20 years, I've had a lot of interaction with the health care system there in many different areas. Do you happen to know what sort of health system the country has, if it was relatable to the U.S. health system at all? Are there any notable differences? So it is a private health care system, and it's basically a multi-tiered system where, because most of the people living in the United Arab Emirates are expatriates. So you're there working for a particular company or a particular person. So that company or that person has to provide you with health care insurance based upon your employment contract that is renewed on a yearly basis. So your health insurance is renewed on a yearly basis. So if you're there with a multinational company, you'll have pretty good insurance and you can kind of go to any private hospital or system, doctor, specialist, whatever you choose. But if you're there as a laborer and you're employed to do labor or like as like a domestic worker or something like that, you have you also have to have private health care. But that particular insurance would only cover you in certain places, certain health care or health hospital areas or clinics. So your experience in those clinics would obviously be different than your experience in a private clinic that is more expensive. And then the Emiratis who are actually from there, which is a very small part of the population, the UAE government actually subsidize all of their health care. So they get basically free health care in the hospitals of their choosing. Interesting. So yours was covered by employee-based insurance? Yes. So basically, like my husband's company would put us on his health insurance and it would be through like Cigna or I forget which insurance we had. But it actually we would have a plan that would allow us to use any private hospital, clinic, doctor, whatever we wanted to use in Dubai. And it had and it paid pretty much, I would say, like 95 percent or more of our visits and our health care. And then also it would cover us being expatriates. It would cover in the U.S. emergency coverage. If we were in the U.S., say like for a holiday and needed to go to the emergency room, it would cover us. That was just the kind of insurance that most multinational companies use. And then but if we needed a longer health care policy in the U.S., we would have to purchase that ourselves and pay for that. So that's very interesting. I didn't know you could use the insurance in the UAE and then also in the U.S. Yeah, well, it has to be that particular policy. And then basically what would happen is that, for example, like when the kids were younger, I would do a lot of their pediatric visits over the summers when we were here, because I'd want to make sure that they were on track for the U.S. system of immunizations and have them with a pediatrician in the U.S. and that sort of thing. So we would do a lot of our visits in the U.S. in the summertime. And then basically I would pay for everything. And then the international insurance usually you submit all of your receipts and then they reimburse you based on what they think is reimbursable, which is usually about 80 percent. Got it. So with your insurance and then just kind of in general, how long did it take to make an appointment? And how was that? How did you kind of do that process in the UAE? Yeah, so actually it's pretty easy if you have very good health insurance like we did. It was you know, we had the higher end expensive insurance. So we would we could I could call up pretty much any hospital specialist doctor and get in fairly easily. I mean, I would say it never took more than a week to get an appointment for anything from dermatology to gynecology. Appointments were very easy to get. But like I said, though, if you were, say, like a domestic worker, you would have to just go to a clinic like maybe on your day off at like eight in the morning and just wait there all day to see if you could get in to see someone. So, you know, there are definitely different levels of treatment. So, you know, of course, we were blessed to have such very good insurance. But, you know, not everyone was as lucky as fortunate as we were. So I guess just kind of a general question. What did you like about your visit? That maybe was something about the health care system there that we could maybe implement in the US. And then what's something that you think could be approved upon in the health system? So the one thing that I liked a lot is that it was just so accessible in comparison to where I am now in Florida. You know, I just it's so difficult to to get to see even just a primary care physician where we are in Florida based on, you know, just the lack of availability of doctors. Whereas in the UAE, I mean, there, you know, there the access to seeing a doctor was just very easy. There are doctors from all over the world that come there to practice. I mean, obviously their credentials have to be at a certain level, but for the most part, you know, they're they're all very good. And so you have a lot of specialists that come there and they want to live there and from their countries like, you know, Lebanon, Turkey, Palestine. You have a lot of Arab speaking doctors, Arabic speaking doctors from neighboring countries that come. And so there's they're just accessible and it's super easy to get in to see them. And then also you have a much more. It's easy to follow up with them as far as getting the face time and getting the responses and getting your questions answered. Whereas I've noticed since I've been back in the US since covid and I've been doing most of my health care here, you know, I will have to call the clinic and I may or may not get a response or, you know, over a day. If I have a question about like a prescription or like if I've had like lab work or test, it just seems like there's just a constant lag time between, you know, you wanting answers and then someone following up with you. So that that was I would say would be the biggest difference. And then what I think that the US might could implement. I'm not sure that really they could really implement anything just because it's just such a different system with so many different. There's just access to so many workers that can come in on visas. So you have you don't have a shortage of nurses or doctors like you do in the US. So and I know in the US they've started recruiting. I know there are there they do recruit from the Philippines to bring nurses into the US just because there is a shortage in some cities. So, you know, I don't know, maybe looking at at giving more work visas to people outside the US to fill the gap or the need that we have in the health care system. Maybe that's one thing that would help. Yeah. So kind of in that same vein. You mentioned that they in the US typically sometimes have doctors and nurses from other countries. Are there any cultural or communication barriers that came along with that? Yeah, I mean, I think I think I was there for so long that I became quite used to all the different cultures. I will tell you that. So when I went there in 2001, I had just had my first child. And so we moved there when my first child was three months old. And then about a year and a half later, I got pregnant again. And with my second child at that time, I was not comfortable enough to actually stay there and and have the have a child there. So I actually came back to the US and the last few months of my second pregnancy and gave birth to the US in the US. And just so I could feel comfortable in my own setting and my system with the nurses and how everything goes. Now, you know, I did have friends around that same time that also gave birth there and their experiences were OK. But, you know, I just knew in the US I would be super comfortable in a setting like that. As the years went on and the health care got better and better and better and more doctors have come in and nurses and hospitals have opened. And a lot more things are more, you know, cutting edge. And it's not I mean, I'm not going to say it was primitive 20 years ago, but I mean, it was definitely you know, they were just working things out then. So now, you know, it's probably, you know, I have no issue staying and, you know, having a child there. But I did have surgery there. Gosh, 2019. And that I was a little bit hesitant about at first because, you know, the experience of actually going in a hospital and meeting your anesthesiologist and meeting your nurses and going through the whole experience of, you know, being put under and having surgery. I mean, for example, the cultural differences were my surgeon was Pakistani and he was a very strict Muslim. And so I was like actually not allowed to touch him in any way, shape or form. But he could touch my I was having elbow surgery. He did touch my arm. But he was very, very strict with like I wasn't able to shake his hand and that sort of thing, which was kind of weird for me. But I understood it because I'd been there a long time. And then so you have your doctor who is from Pakistan who, you know, has these beliefs. You would have like the nursing staff that, you know, was taking care of me. They were all from India. So, you know, which was fine. But you, you know, you have to be comfortable in a hospital setting when you're recovering. And the people around you are speaking to each other in Hindi, which, you know, you don't really understand. But, you know, that can be a little bit nerve wracking for somebody who's, you know, not been in that situation before, where they're used to being out of their comfort zone as far as, you know, not just everyone around you is English speaking. They are English speaking, but, you know, they're just more comfortable speaking to each other in their own language. And then, you know, you have the administrative staff at the hospital who might be, you know, Arab of some sort or Filipino. And so, yeah, so it's just a very like multicultural experience and everybody brings their own sort of, you know, background and experiences to the workplace. So, you know, you just have to, you know, be comfortable with in that kind of environment. So that's really interesting. I didn't know that. It seems like a very unique experience. It has been. Yeah. Yeah. Well, that's all I have for you. Thank you so much for doing this. Thank you.