PHSSR Saudi Arabia 2025

Funding sources In 2019, 30% of the health expenditure came from private sources, with 16% coming from private insurance contributions and 14% from out-of-pocket (OOP) expenditure. Residents working in the private sector are covered by mandatory employer-based health insurance schemes, health insurance providers regulated by the Saudi Council of Health Insurance (CHI) which was established in 1999. Saudi nationals working in the private sector are also covered by these schemes, in addition to their (non-contributory) entitlements to public coverage. The functioning of employer-based health insurance is underpinned by the by the CHI’s Saudi Health Insurance Bus (SHIB), a centralised network and processing system that connects all stakeholders in order to manage and monitor standards-based information exchange between healthcare providers and health insurance companies for the bene fit of all stakeholders, including bene ficiaries. These services are provided by a network of private hospitals throughout the country. Currently, the CHI network consists of nearly 25 insurance companies, with approximately ten million health insurance subscribers who can avail of services from around 5,800 providers (Council of Health Insurance 2022). Over the last few years, due to an exodus of resident workers as a result of measures increase the number of Saudi nationals in the workforce and the negative impact of the Covid-19 pandemic, there has been a decline in the total population covered by private insurance. However, the private health insurance market is expected to grow by about 12% in a base-case scenario and account for 2% of GDP by 2030 (Rahman R, 2020). OOP expenditure comprises spending by Saudi nationals, residents working in both government and private sectors, and people without coverage. People who are unemployed and those not covered by an employer-sponsored health insurance plan are particularly exposed to OOP , and may find it difficult to afford the user charges required to access healthcare services. While the government provides subsidies for some low- income individuals, coverage is limited, and many people struggle to access the care they need. Non-citizens who are self-employed may also struggle to access healthcare coverage if they are unable to purchase private health insurance. Undocumented migrants face signi ficant challenges in accessing healthcare services in Saudi Arabia. While the government provides some healthcare services free of charge, coverage is again limited. There are ongoing efforts to improve healthcare coverage for vulnerable groups. In 2019, the government announced plans to expand healthcare coverage to all citizens and residents by 2030 as part of its Vision 2030 plan. However, it remains to be seen how these plans will be implemented and whether they will effectively address existing challenges in providing healthcare coverage to vulnerable groups. Public healthcare services are provided through MoH, Ministry of National Guard Health Affairs, Ministry of Interior, Ministry of Education (MoE), Ministry of Defence, King Faisal Specialist Hospital and Research Centre, Royal Commission for Jubail and Yanbu, Arabian American Oil (ARAMCO) and many other hospitals and health centres. In recent years, the government has invested heavily in healthcare infrastructure, focusing on underserved regions such as the south and east of the country, and, under Vision 2030 , the government plans to invest over USD$65 billion in the development of healthcare infrastructure. The private sector has also grown through investments in specialised services such as cosmetic surgery, fertility treatments and medical tourism. This expansion is largely as a result of the recently launched National Centre for Privatisation, which is one of the executive programmes launched by the Council of Economic and Development Affairs to achieve the objectives of Vision 2030 (International Trade Administration, 2022). The programme seeks to support the development of the national economy and enhance the role of the private sector in the provision of services and the availability of government assets, implying greater autonomy for healthcare providers and a move away from centralised management. This aims to improve in general the quality of services provided and contribute to the reduction of costs. Furthermore, it aims to strengthen the government’s focus on its legislative and regulatory role, which at present is somewhat challenged by its responsibility 35 Sustainability and Resilience in the Saudi Arabian Health System The Partnership for Health System Sustainability and Resilience