UAE and Gulf insurers are reticent on claims related to reconstructive surgeries - and without a valid reason. Image Credit: Gulf News

Medical insurance policies in the GCC do not cover reconstructive surgery, which many believe is a medical imperative that should not fall under the same category as aesthetic or cosmetic surgery. The lack of acknowledgement of this notion is harmful.

Take mastectomy for instance, a surgical procedure that involves removing breast tissue to treat or prevent breast cancer. A mastectomy must not be considered ‘medically complete’ if breast tissue has not been restored, granting the female cancer patient roughly the same bodily shape she had prior to the breast cancer surgery.

The outcomes of such a life-saving surgery have a physiological and mental impact on female lives. Given the restorative nature of the procedure, it is wrong to categorize it as plastic surgery. Instead, it must be seen as part of the medical course of treatment and an essential therapeutic practice for patient recovery.

Such reconstructive surgeries are indispensable for safeguarding mental health by restoring the natural form of the woman’s body, which is her birthright.

Boosting morale is not cosmetic

Examples of reconstructive procedures that typically fall under medical insurance coverage in other regions include Superficial Inferior Epigastric Artery (SEIA) and Deep Inferior Epigastric Perforator (DIEP) flaps. SEIA and DIEP are cutting-edge breast reconstruction procedures that use a woman’s own tissue to create new breasts after a mastectomy.

These surgeries are known to give female cancer patients self-confidence. The procedures hand women back what cancer had taken away from them.

Some patients have reported higher levels of confidence and comfort with their bodies following these surgeries than they had prior to their diagnosis. Feeling uncomfortable in your own skin after you’ve beaten death is definitely an area requiring medical attention. Having a positive body image of oneself is a precursor to developing and maintaining a state of physical and mental wellbeing.

Six years ago, I performed a DIEP flap on a patient, who went on to pursue a career in sports.

Growing burden of mental health on nations

Beyond the negative impact on patients themselves, the absence of insurance coverage for reconstructive surgery forces nations to carry the full weight of populations’ mental health. The long-term mental health cost on governments far outweighs the medical insurance cost of necessary reconstructive surgery by insurance companies.

A PwC Middle East study revealed that untreated mental illness in the GCC results in the loss of at least 37.5 million productive hours a year, dealing a mighty blow of up to $3.5 billion to the regional economy. About 15 per cent of the GCC’s population grapple with mental health issues in any given year. Excluding reconstructive surgery from medical insurance policies may have an impact on mental health, and therefore adds fuel to the flames.

Geo-economic impact

With remote work on the rise, the lack of medical cover for reconstructive procedures is potentially resulting in hidden economic disadvantages for the GCC. The need for ‘reconstructive insurance’ benefits may push people to live outside the region where they can work remotely for a certain GCC nation, contrary to the aims of GCC governments to attract and retain talent within their borders.

According to a report by Lancet Commission, about 12 billion working days are lost due to mental illness every year. This trend will cost the global economy $16 trillion by 2030.

Immediate action

Instead of addressing mental health problems through reactive treatment, a proactive approach through prevention has never been more important. Due to the cost implications, most mastectomy patients don’t opt for reconstructive surgery and end up delaying their treatment. Over the years, their mental health starts to deteriorate. If insurance policies provided coverage, most patients will likely undergo reconstructive surgeries immediately, averting the long-term mental health implications for them and the nations they reside in.

Insurers’ responsibility

Whether or not these arguments would seem valid to insurance companies, giving back a sense of femininity to female breast cancer patients is not only a medical necessity, but a social responsibility too. It represents a way to give back to society.

Insurers operating in the GCC can take advantage of this underserved area of corporate citizenship by adding a reconstructive surgery cover in their medical insurance policies. This represents a unique form of corporate social responsibility, which can also give insurers a competitive advantage in the region.