لقد كشفت جائحة كوفيد-19 بما لا يدع مجالاً للشك أن الأمن الصحي يتصدر سلّم الأولويات الوطنية. حتى الحكومات التي لم تكن تضعه ضمن اعتبارات السيادة أو خطط التنمية اضطرت إلى إعادة النظر في استراتيجياتها، مدركةً أن الاستقرار الصحي هو أساس الاستقرار الاقتصادي والاجتماعي. فقد غيّرت الجائحة معادلة صنع القرار، وجعلت من الصحة العامة قضية أمن قومي لا تقل أهمية عن الأمن الغذائي أو العسكري.
المؤكد أن الأمن الصحي حق أصيل يتقدم به المواطن على غيره، فهو الحصن الأول للدولة، وعليه تقوم ركائز الاستقرار والتنمية. وقد أدركت الدول، وفي مقدمتها المملكة العربية السعودية، أن حماية صحة المواطن ليست فقط مسؤولية أخلاقية، بل أولوية استراتيجية. فالمواطن هو النواة التي تدور حولها منظومة الأمن الصحي، وكل ما يُبنى لاحقاً من رعاية للمقيمين والزوار، إنما يُبنى على أساس متين من الطمأنينة التي يُمنحها المواطن أولاً.
في الوقت الذي تولي فيه المملكة العربية السعودية صحة الإنسان أهمية قصوى دون تمييز، فإن الواقع يشير إلى وجود أكثر من ثلاثة ملايين عامل منزلي يتمتعون بالخدمات الصحية مجاناً، أسوة بالمواطنين. ورغم أن هذا التوجه الإنساني يعكس التزام الدولة بالقيم الأخلاقية والحقوقية، إلا أنه يشكل عبئاً كبيراً على القطاع الصحي، ويثقل كاهل الميزانية العامة، لا سيما في ظل تحديات النمو السكاني وضغوط الطلب على الخدمات الصحية عالية الجودة. وقد بات من الضروري إعادة النظر في نماذج تمويل الرعاية الصحية للعمالة المنزلية، بما يوازن بين البعد الإنساني والعدالة الاقتصادية، ويضمن استدامة النظام الصحي الوطني.
في ظل التزايد المستمر في أعداد العمالة المنزلية في المملكة؛ التي تجاوزت حاجز الثلاثة ملايين عامل وعاملة، وتقديم خدمات صحية مجانية لهم على مدار السنوات الماضية، أصبح من المُلح إعادة هيكلة منظومة الرعاية الصحية المقدّمة لهذه الفئة، بما يحقق التوازن بين العدالة الإنسانية والاستدامة الاقتصادية. إدراج بوليصة تأمين طبي إلزامية للعمالة المنزلية ضمن رسوم الاستقدام، يتحمّلها المستقدم (صاحب العمل) بشكل مباشر، أسوة بما هو معمول به في أنظمة التأمين الإلزامي للوافدين في قطاعات الأعمال.
يهدف هذا المقترح إلى تحقيق جملة من الأهداف الاستراتيجية، في مقدمتها تخفيف العبء المالي عن ميزانية الدولة والحد من الضغط المتزايد على مرافق الرعاية الصحية الحكومية، مما يُسهم في رفع كفاءة وجودة الخدمات المقدمة للمواطنين والمقيمين على حد سواء. كما يتيح إشراك شركات التأمين المرخصة في تغطية فئة واسعة من المقيمين غير المشمولين سابقاً، بما يعزز دور القطاع الخاص في منظومة التأمين الصحي. إلى جانب ذلك، يُسهم إدراج التأمين الطبي ضمن رسوم الاستقدام في تحقيق العدالة التنظيمية بين فئات العمالة، ويحد من ازدواجية الأنظمة الصحية. وبتقليل الاعتماد على المستشفيات الحكومية في الخدمات الأساسية للعمالة المنزلية، يُمكن توجيه الموارد الحكومية نحو الفئات الأكثر حاجة للخدمة الصحية والدعم المباشر.
ويمثل هذا التوجه انسجاماً تاماً مع مستهدفات رؤية المملكة 2030؛ التي تسعى إلى بناء نظام صحي أكثر كفاءة واستدامة، يقوم على تعزيز الشراكة مع القطاع الخاص، وتحقيق العدالة في توزيع الموارد، ورفع جودة الحياة لكل من يعيش على أرض المملكة. كما يتماشى المقترح مع أهداف برنامج تحول القطاع الصحي، الذي يركز على تمكين التأمين الصحي كرافد رئيس في تمويل الخدمات، وتقليل الاعتماد على التمويل الحكومي المباشر. ومن هذا المنطلق، فإن إدراج التأمين الطبي للعمالة المنزلية ضمن رسوم الاستقدام لا يُعدّ حلاً مالياً فحسب، بل خياراً استراتيجياً يدعم استدامة النظام الصحي ويعزز كفاءة الإنفاق العام، مع الحفاظ على البعد الإنساني والرعاية الشاملة لجميع فئات المجتمع.
علي محمد الحازمي
نحو نظام صحي أكثر كفاءة واستدامة !
5 يونيو 2025 - 00:09
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آخر تحديث 5 يونيو 2025 - 00:09
تابع قناة عكاظ على الواتساب
The COVID-19 pandemic has unequivocally revealed that health security is at the top of national priorities. Even governments that did not consider it within the frameworks of sovereignty or development plans were forced to reconsider their strategies, realizing that health stability is the foundation of economic and social stability. The pandemic has changed the decision-making equation, making public health a national security issue no less important than food or military security.
It is certain that health security is a fundamental right that citizens prioritize over others; it is the first fortress of the state, and upon it rest the pillars of stability and development. Countries, led by the Kingdom of Saudi Arabia, have recognized that protecting the health of citizens is not only a moral responsibility but a strategic priority. The citizen is the nucleus around which the health security system revolves, and everything built later in terms of care for residents and visitors is based on a solid foundation of reassurance granted first to the citizen.
While the Kingdom of Saudi Arabia places the utmost importance on human health without discrimination, the reality indicates that there are more than three million domestic workers who enjoy free health services, similar to citizens. Although this humanitarian approach reflects the state's commitment to ethical and rights-based values, it poses a significant burden on the health sector and weighs heavily on the public budget, especially in light of challenges such as population growth and pressure on demand for high-quality health services. It has become essential to reconsider the funding models for healthcare for domestic workers, balancing the humanitarian aspect with economic justice, and ensuring the sustainability of the national health system.
In light of the continuous increase in the number of domestic workers in the Kingdom, which has exceeded three million, and the provision of free health services to them over the past years, it has become urgent to restructure the healthcare system provided to this group, achieving a balance between humanitarian justice and economic sustainability. Introducing a mandatory health insurance policy for domestic workers as part of the recruitment fees, to be borne directly by the employer, is akin to what is practiced in mandatory insurance systems for expatriates in business sectors.
This proposal aims to achieve a number of strategic objectives, foremost among them alleviating the financial burden on the state budget and reducing the increasing pressure on government healthcare facilities, which contributes to enhancing the efficiency and quality of services provided to both citizens and residents alike. It also allows for the involvement of licensed insurance companies in covering a wide category of residents previously not included, thereby enhancing the role of the private sector in the health insurance system. Additionally, including health insurance within recruitment fees contributes to achieving regulatory justice among labor categories and reduces the duplication of health systems. By decreasing reliance on government hospitals for basic services for domestic workers, government resources can be directed towards the most needy groups for health services and direct support.
This approach represents complete alignment with the objectives of Saudi Vision 2030, which seeks to build a more efficient and sustainable health system based on enhancing partnership with the private sector, achieving justice in resource distribution, and improving the quality of life for all who live on Saudi soil. The proposal also aligns with the goals of the Health Sector Transformation Program, which focuses on empowering health insurance as a primary source of funding for services and reducing reliance on direct government funding. From this perspective, including health insurance for domestic workers within recruitment fees is not merely a financial solution but a strategic option that supports the sustainability of the health system and enhances the efficiency of public spending while maintaining the humanitarian aspect and comprehensive care for all segments of society.
It is certain that health security is a fundamental right that citizens prioritize over others; it is the first fortress of the state, and upon it rest the pillars of stability and development. Countries, led by the Kingdom of Saudi Arabia, have recognized that protecting the health of citizens is not only a moral responsibility but a strategic priority. The citizen is the nucleus around which the health security system revolves, and everything built later in terms of care for residents and visitors is based on a solid foundation of reassurance granted first to the citizen.
While the Kingdom of Saudi Arabia places the utmost importance on human health without discrimination, the reality indicates that there are more than three million domestic workers who enjoy free health services, similar to citizens. Although this humanitarian approach reflects the state's commitment to ethical and rights-based values, it poses a significant burden on the health sector and weighs heavily on the public budget, especially in light of challenges such as population growth and pressure on demand for high-quality health services. It has become essential to reconsider the funding models for healthcare for domestic workers, balancing the humanitarian aspect with economic justice, and ensuring the sustainability of the national health system.
In light of the continuous increase in the number of domestic workers in the Kingdom, which has exceeded three million, and the provision of free health services to them over the past years, it has become urgent to restructure the healthcare system provided to this group, achieving a balance between humanitarian justice and economic sustainability. Introducing a mandatory health insurance policy for domestic workers as part of the recruitment fees, to be borne directly by the employer, is akin to what is practiced in mandatory insurance systems for expatriates in business sectors.
This proposal aims to achieve a number of strategic objectives, foremost among them alleviating the financial burden on the state budget and reducing the increasing pressure on government healthcare facilities, which contributes to enhancing the efficiency and quality of services provided to both citizens and residents alike. It also allows for the involvement of licensed insurance companies in covering a wide category of residents previously not included, thereby enhancing the role of the private sector in the health insurance system. Additionally, including health insurance within recruitment fees contributes to achieving regulatory justice among labor categories and reduces the duplication of health systems. By decreasing reliance on government hospitals for basic services for domestic workers, government resources can be directed towards the most needy groups for health services and direct support.
This approach represents complete alignment with the objectives of Saudi Vision 2030, which seeks to build a more efficient and sustainable health system based on enhancing partnership with the private sector, achieving justice in resource distribution, and improving the quality of life for all who live on Saudi soil. The proposal also aligns with the goals of the Health Sector Transformation Program, which focuses on empowering health insurance as a primary source of funding for services and reducing reliance on direct government funding. From this perspective, including health insurance for domestic workers within recruitment fees is not merely a financial solution but a strategic option that supports the sustainability of the health system and enhances the efficiency of public spending while maintaining the humanitarian aspect and comprehensive care for all segments of society.


