The Expected Impact of the New Iraqi Health Insurance Program and the Challenges Facing its Implementation: Physicians’ Perspective

Aim of the Study: The aims of study were to explore the physicians' insights toward the impact of prospective implementation of the Iraqi Health Insurance Program (IHIP) on patients, healthcare providers (HCPs) and services and identify the potential challenges facing its implementation. Method: This was a qualitative study including semi-structured face-to-face interviews with specialist physicians from different disciplines (Internal medicine, family medicine, cardiology, orthopedic, oncology, gynecology, general surgery, pediatricians and dentistry). The interview guide included open-ended questions about the impact of the IHIP on patients and HCPs at three levels: quality of services, costs, and frequency of visits. Potential challenges were also discussed. Interviews were conducted in six provinces from April 19th to August 2022. Thematic analysis was used to analyze the interview findings and generate themes and subthemes. Results: The study recruited 26 physicians till the saturation point has been reached. Only sixteen from the participants were aware of the IHIP. Most participants believed that the program could enhance patient health and would increase the income of HCPs in the private sector. They also expected that patients would use private-sector services more frequently. Additionally, the implementation of the health insurance can improve the quality of healthcare services and reduce the financial burden regarding private sector fees. The potential challenges of the program implementation include corruption, provision of comprehensive medical services to insured people, overuse of the plan by the insured patients, convincing non-governmental employees to join the health insurance plan and potential delays in the reimbursement to HCPs. Conclusions: The IHIP has several potential advantages, but at the same time, it can face several technical challenges. Thus, the program should be well studied before being implemented, and it needs to be piloted at a small scale before national implementation. Electronic health system must be adopted to facilitate transferring data to health insurance authority. Hiring international experts to help managing the medical claims is pivotal to avoid delaying in the processing. Finally, the Health Insurance Authority (HIA) needs to raise the awareness of HCPs and people about the national health insurance plan.