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The Buzz

Business briefing: 30 May 2013

by Executive Staff May 30, 2013
written by Executive Staff

Economic and Policy

Syria’s oil production has crashed to 20,000 barrels per day, or 5 percent of its prewar output, Oil Minister Sleiman Abbas said.

More from AFP

Egypt is failing to carry out privatization policies that could help rebuild the economy.

 
More from Reuters

Oman’s government is considering a proposal to issue dollar-denominated sovereign bonds sometime in 2014, which could lead to regular debt sales in the future.

More from Reuters

 

Companies and Business

Islamic Development Bank (IsDB), a Jeddah-based multilateral institution, raised $1 billion from the sale of a five-year Islamic bond, or sukuk, at par on Wednesday, overcoming a sell-off across global credit markets.

More from Reuters

Abraaj Group, the Dubai-based private equity firm with $7.5 billion in assets, is among Gulf investors targeting acquisitions in North Africa as a surging population boosts demand for products from health care to food and banking.

More from Bloomberg

Middle East airlines saw their freight business expand by 8.6 percent last month, according to figures released by the International Air Transport Association (IATA).

More from Arabian Business

Lebanon's Public Housing Institute has warned citizens running late on mortgage payments that they would face legal action if they failed to settle their accounts by June 5.

More from The Daily Star

May 30, 2013 0 comments
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Economics & Policy

Finally, some good news for America

by Thomas Schellen May 30, 2013
written by Thomas Schellen

The United States has regained the title of the world’s most economically competitive nation, the latest global rankings publication by Swiss business school IMD show. The United Arab Emirates made the greatest improvement of any country, rising eight places to reach the top ten.

See the full interactive list of the world’s most competitive places

Evaluating 60 countries from analyses of 130 hard and 116 survey-based data for each nation, the IMD 2013 World Competitiveness Yearbook (WCY), released today, shows the US rising to the top after being overtaken by Hong Kong in 2012. The latter drops to third, with Switzerland, Sweden, and Singapore making up the top five.

The UAE and Qatar appear in positions eight and ten as best-ranked countries from the Middle East and North Africa region, with the UAE’s gain of eight positions allowing it to push ahead of unchanged Qatar. The UAE, which were first covered in the 2011 WCY, has advanced by 20 ranking positions in the past two years, more than any other country.

IMD attributes the return of the US to the top to a “rebounding financial sector, an abundance of technological innovation and successful companies.” A look at the US country profile reveals that the country has leapt higher in business efficiency but dropped in government efficiency – with relations between rival Democrat and Republican politicians reaching new lows in recent months.

Taking austerity lightly

In interpreting the trends of the study, Professor Stephane Garelli, director of the IMD World Competitiveness Center, emphasizes the role of social cohesion for competitiveness and warned against taking austerity too far. “The robust comeback of the US to the top of the competitiveness rankings, and better news from Japan, have revived the austerity debate,” he said. In his view, structural reforms are unavoidable but growth is the inescapable prerequisite for competitiveness, cautioning that “the harshness of austerity measures too often antagonizes the population. In the end, countries need to preserve social cohesion to deliver prosperity.”

UAE follows the USA

While they are very different animals, the US and the UAE share one characteristic in the perceptions of respective local business leaders: both countries impress most by their economic “can do” energy. Of 15 parameters in the survey, “dynamism of the economy” was named most often as an attractive factor in both countries, by 57.4 percent of American executives and by 38.8 percent of their peers in the UAE.

Business leaders in competitive European countries such as Switzerland and Germany chose the top attractiveness points of their economies rather differently, as “policy stability and predictability” in the former and “skilled workforce” in the latter.

Whether or not one sees these opinions as indication that stereotypes also exist among business leaders, it is instructive to contrast most-picked attractiveness indicators with the least-picked in a country. In the US, only 5.9 percent of business leaders believe their country to have a competitive advantage in a “favorable tax regime” whereas 30.6 percent of Emiratis say they do. A high education standard in their country, on the other hand, is not an attractiveness indicator for any business leaders in the UAE, unlike in the US (30.7 percent), the United Kingdom (38.9 percent), Switzerland (53.9 percent), Germany (55.5 percent) and South Korea where “high educational level” was the top attractiveness point and selected by 77.9 percent of respondents.

Compare and contrast

It is quite enticing to compare the WCY with the Global Competitiveness Report (GCR) published annually by the World Economic Forum. While a director of the World Economic Forum (WEF) in charge of the GCR told Executive recently that there is not much competition between the two providers, this seems implausible.

Discrepancies between WCY and GCR are not only noticeable but sometimes significant, such as in the case of Finland which was ranked it the top 3 percent (third out of 144) by WEF but barely made the top third (20 out of 60) at IMD. Qatar looks almost twice as good with WEF (top Arab country and 11th of 144 overall) than with IMD (10th of 60); inversely, WEF has the United Arab Emirates in a good position (24) but not quite as high as it sees Qatar.

Some of these discrepancies may be traceable to the differences in methodology – IMD emphasizes hard data in assigning its rankings and the WEF directs more attention to the perceptions of business leaders surveyed.

May 30, 2013 0 comments
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Business

Building on the spirit of Tahrir

by Joe Dyke May 30, 2013
written by Joe Dyke

In the coming months, Executive is seeking to highlight exciting entrepreneurs from Lebanon and across the Arab world. Every Thursday we will introduce our audience to one of the new generation of exciting talents to learn how they are seeking to change the Middle East.

 

Company: Qabila

Country: Egypt

Industry: Media

Founder: Perihan Abou Zeid

Age: 28

Established in: 2010

Number of employees: 21

Revenues last year: $215,000 in 2012

Capital raised: Currently seeking a deal to raise $300,000-400,000

Awards: Best female entrepreneur — 2012 MIT Enterprise Forum. Selected among top five startups in Africa by Demo Africa and among the top 50 startups globally by Global Entrepreneurship Week.

 

Perihan abou-Zeid’s parents were not entrepreneurs, but she was always going to be one. She recalls how, growing up in Egypt, she first started trying to make money at the age of six by drawing stories and trying to convince her cousins to buy them. By the age of 12 she had moved on to bigger markets.

“I started creating bracelets with threads that you can write a person’s name on and selling them to my friends. I made a fortune off of that — I made close to $2,000,” she says. With that kind of natural talent for turning ideas into profit, Zeid was perhaps destined for success.

Perihan Abou-Zeid is Qabila’s Chief Executive Officer

 

Yet it was not for over a decade, and after a degree in business at the American University of Cairo, that her entrepreneurial drive would be put to good use, helping spur on the Egyptian revolution. In 2010, 25-year-old Zeid was feeling rather despondent about the state of Egypt’s politics. “It was a depressing year: corruption had skyrocketed [and] forged elections gave the ruling party 99 percent or something. So the youth was very frustrated and the media reflected something completely different from the reality,” she says. “66 percent [of people] are under the age of 35 in Egypt and for us it was just wrong [that content didn’t appeal to them] and we thought of doing videos that could change that.”

So Zeid and her friends (the company started more as a collective) formed Qabila, beginning by making a series of videos explaining Arabic proverbs, which she, perhaps modestly, now describes as “really bad.” They were finished but got little attention, with the group somewhat disappointed in their efforts – the threat of failure loomed.

Related article: EKeif seeking to dominate Arabic content online

But then fate intervened. Just weeks later North Africa was gripped by revolutionary fervor that would eventually bring down Egypt’s dictatorial president Hosni Mubarak. Qabila (which means tribe in Arabic) again sprang into life, creating a spate of videos — including the series that shot them into the limelight: the beginner’s guides to politics.

Using deliberately non-technical terms, the videos were hugely popular with a people making their first steps towards democracy. They went viral online, and within a few months, “the Supreme Judicial Council for Parliamentary Elections knocked on our door asking to produce a campaign encouraging people to vote,” Zeid recalls. “From that point onwards we registered as a company and basically made profits from our first year of operations.”

The company now has contracts in eight different countries supplying video content for both the traditional media — such as Al Jazeera — and online campaigns. Crucially, Qabila has continued to successfully straddle the line between online and offline — using the former to increase their popularity and the latter to increase revenue. They have also continued with an unusual crowdsourcing method of content production, with over 2,000 people having been involved in production in two years.

“The typical way of creating media is the company creates a pilot episode of production and go to TV channels to sell it. We did the complete opposite,” Zeid explains. “We realized that the rightful owner of the power of evaluation and selection of what content should go public is the audience, not the money or the owners or the big channels.” Thus videos would be tested and discussed online, with traditional media sometimes buying it after it went viral.

This innovative method of creating content has seen the company win a slew of awards, including Zeid herself being selected as the best female entrepreneur in the Middle East at the 2012 MIT Enterprise Forum.

And there is little chance of Qabila slowing down. Zeid says that television channels are beginning to catch up as they realize the future is digital, and thus the company has major plans to expand to keep ahead of the competition. Among recent innovations is a pan-Arab film contest with the aim of improving the talent pool of filmmakers in the Middle East, while they are also launching an academy to turn high-level amateurs into media professionals.

And they have set themselves one very optimistic target for an independent film company. “By our fifth year of operation we want to get into production of feature films, that is why we need more talent,” Zeid says. With plans to raise their first round of capital in the coming months and thus open offices in the Gulf, the company seems to be successfully positioning itself at the front of a booming industry.

May 30, 2013 0 comments
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The Buzz

Morning briefing: 29 May 2013

by Executive Staff May 29, 2013
written by Executive Staff

Economics and Policy

France has drawn up a blacklist of 17 countries including Lebanon that do not help investigate foreign aid fraud, banning the use of their banks to help distribute development funds.

More from The Daily Star

 

Qatar may abandon its peg to the US dollar when the economy grows less dependent on hydrocarbons and local financial markets deepen, its central bank chief has said.

More from Reuters

 

Tens of thousands of foreign workers are trying to leave Saudi Arabia after the government said they would be forgiven any fees or fines for visa violations such as overstaying or switching jobs.

More from Reuters

 
Led by the UAE, the issuance of debt securities in the GCC recorded a strong pick-up in the first quarter to hit $16.7 billion, underscoring a sustained recovery.
 
More from Khaleej Times
 
 
Companies and Business

Kuwait's state-run oil group signed a 147 million dinar ($514 million) contract with South Korea's Daelim Industrial Co. to build and upgrade facilities at an oil refinery in the Gulf Arab state.

More from Reuters

SITA, a global air transport IT firm, has been selected by the Directorate General of Civial Aviation Authority and Middle East Airlines-Air Liban to provide airport services at Beirut’s Rafik Hariri International Airport for the next five years.

More from Reuters

 

May 29, 2013 0 comments
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The Buzz

Packing their bags?

by Joe Dyke May 29, 2013
written by Joe Dyke

A row has broken out between European ambassadors and a Lebanese news agency after they reported Western governments were preparing to evacuate their citizens.

The LibanCall news service carried a report on Sunday in which they alleged that European states were preparing to evacuate their citizens from Lebanon following the mortar attacks that injured four people in southern Beirut on Saturday night.

European Union (EU) representatives denied the report and the agency has refused to apologize for the claim.

Related article: Lebanon sucked in to Syria

“European embassies are being [sic] ready to evacuate their nationals from Lebanon, a source told LibanCall” the up-to-the-minute wire agency reported.

Danish Ambassador Jan Top Christensen said there was no truth to the claims, accusing LibanCall of poor-quality journalism. “They don’t allow themselves time to check the information. If they had checked with the head of the EU delegation they would have been told this was incorrect information,” he told Executive.

Christensen said that the European Union formally asked the company to send a message correcting for the message, but they refused. He added that they had decided to stop subscribing to the LibanCall service after the report.

“Things like [this are] serious misinformation — they didn’t want to correct it, we tried from an EU side but they referred to freedom of expression, so I said we will talk about freedom of subscription,” he quipped.

A representative of LibanCall, who did not want to be named, told Executive that they stood by the story and claimed that sources in multiple European embassies had tipped them off about the plans.

Christensen added that he had been dissatisfied with the service provided by the company for some time, and that he felt much of Lebanon’s media was motivated by political motivations, rather than objectivity.

“There is some serious [political] editing at the newspapers…unfortunately there is little tradition of critical journalism – where they really review the so-called information and check views expressed by one person with maybe the opposite,” he said.

May 29, 2013 0 comments
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GCC

A Gulf of Masterpiece

by Executive Staff May 28, 2013
written by Executive Staff

In the current economic uproar of Gulf markets, art is in the spotlight, and among the various genres, Iranian works are in high demand in Dubai.

“Galleries have been progressively setting up shop in Dubai for the last five years; today there are some 25 of them,” said Myrna Ayad, special project manager at Mixed Media Publishing, owners of the art magazine Canvas. The growth of the UAE art scene has been dovetailed by the advent of fine art auctioneers and valuers such as Christie’s or Bonhams, recently establishing offices or organizing auctions in the Emirates.

Initiatives such as the Dubai and Abu Dhabi art fairs have contributed significantly to developing the scene. Other events, such as  hosting the collection of Jewish Persian Nasser David Khalili — one of the wealthiest men in England —  have placed Dubai on the international cultural map. Sharjah having been named cultural capital of the Arab world in 1998 was another factor contributing to the development arts in the UAE.

The Middle East’s social landscape also plays in promoting art. “Its large diasporas include artists who fled their home countries due to political tensions, whether from Iraq, Lebanon or Iran,” Ayad underlined. Most artists are sponsored by other nationals residing in the West or in the Gulf, as shown with Iranian communities on the US West Coast and Iraqis in London.

Cosmopolitan cities like Dubai and Abu Dhabi have benefited to a great extent from this particular trend. Home to affluent communities who view art as another essential asset after their yacht, plane or house — according to Ayad — she noted that art is increasingly acquiring the role of a status symbol.

She pointed out that the UAE art scene has been pulsating for the last six years. When it comes to art forms “the collectors’ focus has been mostly on contemporary art, but modern art has also been gaining attention.”

Iran in demand

Iranian art, whether in the form of paintings, sculptures or installations, is widely accepted in the UAE, according to Mira Khoubrou, managing director at the XVA gallery, adding that “Iranians are among the most sought after artists on the Dubai art scene. Their productions are shown in galleries and have been collecting the highest prices at auctions around the country.” According to her, Iranian artists are frequently choosing Dubai as a base.

In the UAE’s large avenues, all the talk is on prominent artists such Faredoun Ave, Reza Derakshani and Ramin Harizadeh whose works include photography, installations or paintings. “Dubai’s particular location on the world map, close to Iran and of easy access to the Middle East and Europe, accounts probably for the development of Iranian art on the country’s scene, with pieces that were previously only exhibited in Iran showcased in galleries around the city,” explained William Lawry of Christie’s.

Ayad reckons that Iranian art has generated top dollar at recent charities and auction events including the rotating Magic of Persia auction. Pieces by Farhad Moshiri were recently sold for about $500,000 at a first auction, for $600,000 during the Magic of Persia event and for $900,000 at the recent Bonhams auction. Sherine Neshat is another mover and shaker of the Iranian art scene, with the artist’s mixed media creations having fared extremely well around the world.

The pretty Persian penny

In the last few years, the value of Iranian art has increased dramatically, propelled to new heights by Iranian collectors. “Pieces by Iranian artists are priced on the average in tens of thousands of dollars, with some varying from $60,000 to $300,000. Such figures exceed by far original levels witnessed only a few years ago,” explained Khoubrou who believes that purchases by Iranian collectors account currently for more than 60% of total Iranian art sales.

Reza Derakshani, an artist whose collection is on display at XVA, agrees with this figure. “Dubai has been following a trend long set by Tehran where most collections are still, up until now, privately owned. Demand for Iranian art has been growing steadily and I’ve noticed at the recent Bonhams collection that Iranian collectors were competing for certain pieces,” he said.

According to Lawry, higher prices for Iranian art are encouraging sellers to place pieces of finer quality on consignment. Khoubrou concurred, stating that “we have more and more requests from companies who wish to develop their private collections. In such a context, the amount of liquidity witnessed by the region is certainly helping the art scene.”

Maneli Keykavoussi, head of Middle Eastern markets at the Fine Art Fund Group believes that demand is fueled by scarcity of supply in an environment where collectors and museums are not natural sellers. Collecting art is a long tradition in Iranian society, which saw a peak at the time of the last shah, under the patronage of his wife, Farah Diba.

A diverse crowd, Iranian collectors can be divided in two main groups. The first is comprised of an older and more affluent group of connoisseurs while the second, younger group includes art aficionados who either wish to establish their own private collections or are simply looking into a new and more profitable investment class. Keykavoussi underlined the emergence of art as a new asset class: in the last few years the Fine Art Fund, which is a close-ended fund, has witnessed an IRR of cash on cash return of 59.68%, and 36% on assets sold.

“Art is moving out into the investment field. Its low correlation with the equity and money markets and negative correlation with the bond market makes it less susceptible to a downfall and positions it as a new hedging tool,” she adds. As an example, the Indian art scene turnover has grown from $20 million to $400 million dollars per year. “I do not see why this trend could not be applied as well to the Middle East region,” she said.

Iranian art in Dubai is mainly marketed through galleries and action houses. Derakshani reckons he is usually either approached by gallery owners or has contacted them directly. On the other hand, Ayad believes that Canvas has certainly contributed to the promotion of the local art scene through their worldwide distribution network and attendance of art fairs.

“Institutions such as Christie’s and Bonhams have also helped shaping the sector,” she added. With galleries sprouting in Dubai’s older quarters, art has certainly been given a new address de charme.

Arab patrons, although choosing to maintain a low profile, are also scouring the region in search of the perfect oeuvre d’art — their personal master piece, and indirectly tend to ultimately set a benchmark for art pieces and define what’s hot and what’s not, Ayad believes.

The young project manager underlined that it is not Iranian art that has become necessarily more popular but the whole Middle East that is emerging as a new art scene.

“Iran is large country with a sizable expatriate community, while Iranian art is definitely popular, but so is Middle Eastern art, after Indian and Chinese art,” she concluded. At a recent Christie’s auction Middle Eastern art reaped some $12.6 million, with Iranian art along accounting for $5 million.

“Although at the 2006 auctions, Iranian art was mostly sought after by Iranian collectors, of late it has generated more international interest, especially from Arab collectors,” Lawry pointed out, and added that the 2007 Christie’s auction, the first and second largest buyers of Iranian works were Europeans, while the third was an Arab .

May 28, 2013 0 comments
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The Buzz

Morning briefing: 28 May 2013

by Executive Staff May 28, 2013
written by Executive Staff

Economics and policy

The price of oil fell on Monday as traders concerned about global energy demand took profits ahead of economic data from China and the United States.

More from Associated Press

 

Elsewhere on Monday, Gold rose –extending its gains after its strongest week in a month, as the dollar slipped and European stock markets steadied, while physical buying remained strong in Asia.

More from Reuters

 

The economy in Lebanon's second city of Tripoli is rapidly deteriorating, local business associations have warned, as they reiterated calls for calm to be restored following another wave of clashes in the northern city.

More from The Daily Star

 

The opposition Syrian National Coalition is on the brink of collapse after five days of fractious wrangling.

More from The National

 

Kuwait has granted fellow Gulf Arab state Oman $2.5 billion to fund development projects as part of a regional programme initiated in 2011 after protests, Oman's state news agency reported on Monday.

More from Reuters

 

Companies and Business

Qatar Telecom QSC has raised $12 billion to finance its bid for a majority stake in Maroc Telecom SA as it seeks to expand through acquisitions, its chief executive officer said.

More from Bloomberg

 

Qatar has unveiled plans to build a $5.5 billion island off the coast of Doha with floating hotels to house football fans expected to flock to the country for the World Cup in 2022.

More from Reuters

 

Hotels in Abu Dhabi have posted their best ever results for April, according to figures released by the emirate's Tourism & Culture Authority (TCA Abu Dhabi).

More from Arabian Business

 

Construction work has started on a new state-of-the-art surgery facility at Hamad General Hospital in Qatar.

More from Reuters

 

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Economics & Policy

Sucked in

by Zak Brophy May 28, 2013
written by Zak Brophy

Despite the government’s official policy, Lebanon has never been truly dissociated from the Syria conflict. However, until late the involvement of Lebanon’s divergent factions across the border has been covert, opaque and from afar. In this past month, that has changed — bringing the conflict ever closer to home.

The deteriorating security situation is perhaps not surprising but it is disturbing. On a trip in early May to the Hezbollah stronghold of Hermel, north Lebanon, Executive stood with local residents as they inspected the red hot tail of a rocket that had just crashed into a hillside overlooking a family fairground. “This is not the first and it won’t be the last,” one of them said. Correct, he was.

As he spoke Hezbollah was escalating its involvement in the bloody battle for the town of Qusayr, eight kilometers into Syria. A rise in the number of their fighters coming home in body bags has followed.

Related articles: State failure breeds fanaticism

The EU's pointless Syria gesture

Perhaps inevitably, as violence in the socially and economically dislocated Beka’a grew, the conflict enflamed again in Tripoli — the scene of on-off battles between groups in support of and opposed to Syrian president Bashar al-Assad for years. The body count from more than a week of fighting reached 29, including two Lebanese soldiers.

Then on Saturday, Hezbollah leader Sayyed Hassan Nasrallah delivered a speech that defiantly nailed the party’s colors to Assad’s mast. Describing the government in Damascus as the “backbone” of the resistance to Israel, Nasrallah declared, “We entered a new phase a few weeks ago: the phase of fortifying the resistance and protecting its backbone.”

Only hours after Nasrallah had proudly declared his party’s involvement in Syria, the violence within Lebanon completed its advance to the capital Beirut with two 107mm rockets slamming into the Shia and Hezbollah dominated Shiyeh southern suburbs. Five people were injured — and another unsettling line was traversed.

A battle for confidence

All of this is catastrophic for confidence, which is paramount for the Lebanese economy. One need just look at Banque du Liban’s — Lebanon’s central bank — coincident indicator (which gauges the country’s economic activity) to see how responsive the economy is to political and security developments. “In Lebanon confidence is the most important thing. Politics is 95 percent of it. You can feel it from the restaurant to the stock market,” observed Mazen Soueid, chief economist BankMed.

Foreign direct investment and consumer confidence have nosedived and growth in the economy plateaued at 1.2 percent over 2011 and 2012. A reflection of this debilitated situation came with the Moody’s downgrade in mid-May from stable to negative for the outlook on government bonds and for the deposits ratings of the country’s three biggest banks.

The security crisis is both related to and compounded by the almost complete paralysis of the political establishment, and this in turn is further stripping whatever confidence remains that Lebanon can shelter its economy from the Syrian tragedy. “We really need a government that can neutralize the economy from the political environment; this is especially true with everything that we see today,” said BankMed’s Soueid.

However, the resignation of Prime Minister Najib Mikati in late March has stripped the executive branch of its ability to pass any new decrees — reducing it to little more than the guardian of day-to-day business. Furthermore, despite the media circus of negotiations, it is now highly likely that the lack of consensus on a new electoral law will mean parliament’s term will be extended — a move that is constitutionally dubious to say the least.

Perhaps the biggest indicator of the lack of faith in politicians and the government to help shore up the flagging economy is the increasingly vocal reticence of Lebanon’s powerful banking sector to keep on unconditionally financing the national debt. “The banks have reduced their exposure to Lebanese pound-denominated treasury bills and while we continue to exchange Eurobonds I don’t think we will continue to indefinitely subscribe if there are no concrete reforms,” warned Nassib Gobril, head of research at Bank Byblos.

The central bank has stepped in to fill the void and buy up government papers in what is ultimately a short-term fix to an unstable and unsustainable situation. For now this intervention will keep the government afloat and stop interest rates from spiraling skyward, which would further hobble the economy.

Restoring some vestiges of confidence in the economy is first and foremost predicated on security. Although this month’s events don’t bode well, a good first step would be if all the involved parties, and they are plenty, were to step back from the affray, tone down the vitriol and show some commitment to the welfare of Lebanon.  

If at least a veneer of stability can be maintained then perhaps the nation and its economy can be saved from being washed up on the rocks. This of course requires concerted political will. As the seeds of sedition are strewn around us, it is a tough ask to expect anyone to fix that conundrum.

 

In next month’s magazine, out on Saturday, Executive will dig deep into the country’s banking sector and whether it is the last hope for a faltering economy. To subscribe click here.

May 28, 2013 0 comments
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Economics & PolicyHealthcare in Lebanon

The cost of quality diagnosis

by Thomas Schellen May 27, 2013
written by Thomas Schellen

Operating a high-end diagnostic center in Lebanon may be  life saving, commendable and personally rewarding, but the financial returns are unlikely to match those from a plastic surgery outfit. 

Imbalances in the public and private sector reimbursement systems for diagnostic exams have distorted yields, conclude the partners of Doctors Center Radiology (DCR), a $10 million dollar facility established in 2000 in Beirut’s Hamra district.

Related article: Lebanon’s declining health spending

Danger awaits an unhealthy sector

“Some months we are in the negative, and some months we are in the positive,” says Dr. Anis Nasser, the center’s co-chief radiologist and founding medical strategist. “We are overall positive [in the financial results] but not as greatly positive as everyone imagines, due to the policy of the Lebanese government and the insurance companies.”

He tells Executive that inflation, expanding overhead costs and capital expenditures have weighed down the center’s bottom line. Meanwhile, compensation rates from the National Social Security Fund (NSSF) and commercial insurers have remained the same over many years, or have even decreased.

The financial compensation of diagnostic centers is not necessarily correlated to the quality of their physicians and equipment, adds Dr. Sami Faddoul, medical partner with Dr. Nasser in the venture and an assistant professor of radiology at Columbia University in New York. 

“Unfortunately, in Lebanon nothing is standardized. You could have a [magnetic resonance imaging] machine that costs $50,000 and a machine like ours that costs $1.5 million. You can imagine the difference. But both [scans] are called an MRI and both are paid at the same rate by insurance companies and the NSSF; the reimbursement is the same.” 

Nasser and Faddoul say that Lebanon is home to “hundreds” of diagnostic centers. 

By their self-assessment, Doctors Center Radiology is the busiest center in the country and one of very few that have a full range of advanced radiology machines. They did not disclose to Executive the average daily number of patients at the facility, which employs four specialists and 45 staff members.

Healthy competition

The business model of Doctors Center Radiology is built on two pillars: quality diagnostic machinery and physicians, and strong customer service. 

DCR also benefits from a favorable address. Since its inception, the center banked on locating its premises near to the American University of Beirut Medical Center (AUBMC). Nasser says he is well known to the doctors at AUBMC and has drawn referrals from them since he opened the center. 

The relationship between the center and AUBMC is more one of collaboration than competition, Faddoul adds. Patients who would have to wait days for a radiology exam at AUBMC can expect a faster treatment at DCR because its customer service is more flexible than the bureaucracy of the quasi-public university hospital.  

Competition for business among radiology centers nonetheless appears intense and the impending creation of a rival center in a new building next door on Bliss Street is not a cherished arrival, judging from subdued comments by the two doctors. 

Still, the doctors describe the interplay of clustering and constructive competition among diagnostic centers  as beneficial overall because it pushes the providers to continually improve. 

When the center invests into a new state-of-the-art MRI or positron emission tomography (PET) scanner, other centers and hospitals are provoked to upgrade to the same level, according to examples cited by Nasser.   

Top dollar diagnosis…

Radiology is a “cornerstone in making an early and proper diagnosis”, says Faddoul. The discipline  employs traditional X-rays, positron emission tomography (PET), and everything in between. Faddoul adds that because radiology is dependent on technology, it is the fastest growing specialty. “Every year there is a new modality and a new way of medical diagnosis.” 

Because of this, it is imperative for radiologists to install the highest quality — and therefore highest cost — machinery to achieve the best results. 

The machines of the highest diagnostic capabilities, however, are sometimes operated at a revenue loss because the center is reimbursed at sub-par rates from commercial insurers or the NSSF, both of which are indifferent to the higher complexity of the advanced scans. 

DCR’s investments in the top machines pay off, though, because they attract patients to the center and increase the facility’s market share. The resultant higher usage rate of the entire set of radiology equipment translates into higher profitability on the balance sheet.

“We believe that quality pays, and we are not stupid,” says Faddoul. “We did not buy a $2.5 million MRI machine just because we have a lot of money and want to spend it on machines. Our philosophy is quality; so we invested in quality and are cashing in on quality. “ 

Patients are the main beneficiaries where competition on quality induces operators to invest in having top machines and top physicians. 

…pays its way

The biggest remaining problem then, is the inadequacy of fees that the NSSF and insurers are willing to pay. In being agnostic on the quality of the diagnosis, commercial insurers push their policy holders to rely on cheap diagnostic centers, both Nasser and Faddoul lament.   

According to Faddoul, the insurers are ill-advised and they risk losing large amounts by the way in which they direct their policy holders to radiology centers. “The majority of insurers push their policy holders to go to the cheapest places, and cheapest means bad quality,” he says. “If you give patients a bad diagnosis, it means bad surgery, and whatever you save on the MRI makes you end up paying big money in extra hospital costs.”

He recommends that insurers commission studies comparing hospital admission rates from cheap, mid-range, and high-end radiology centers. Variances in admission rates and hospitalization costs will highlight the long term cost-savings inherent to higher-quality radiology.

Diagnostic centers can compensate for price pressures from low reimbursement rates only to a point without jeopardizing the quality of their exams, says Nasser. He adds that investments in latest generation machines can be delayed if amortization of the equipment takes extra years.

The NSSF recently announced upward compensation adjustments for radiology scans, but raising the payment for an ultrasound scan of the kidneys from $40 to $48 was not enough to compensate the cost increases that operators have faced in the past few years, Nasser notes. 

This all notwithstanding, the business skill set of operating a diagnostic facility is in substantial demand and Nasser sees regional and domestic growth potentials for Lebanese radiology centers, despite the issues they face. He admonishes, “Things are not as bad as they may appear but what is bad is that there is no control over quality, no control over qualification of doctors and no control over prices.”

May 27, 2013 1 comment
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The Buzz

Morning briefing: 27 May 2013

by Executive Staff May 27, 2013
written by Executive Staff

Economics and Policy

The resignation of Kuwait’s oil minister Hani Hussein has been accepted, local media reported, after he came under pressure from lawmakers wanting to question him over a $2.2 billion compensation payment to Dow Chemical Co.

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Arab spring countries face rising social tensions that could thwart an early economic recovery from over two years of political turmoil that has worsened fiscal pressures and threatens macroeconomic stability, a senior IMF official said over the weekend.

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The United States has launched a $4 billion development fund aimed at transforming the economy of the West Bank and restarting the Israel-Palestinian peace process.

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Just three percent of UAE workers are happy with their current salary, according to the findings of a poll, while 67 percent believe they are underpaid compared to their industry peers.

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Companies and Business

Dubai mall developer Majid Al Futtaim Holding is looking to raise at least $500 million from the issue of a hybrid debt sale to finance its buyout of French hypermarket chain Carrefour’s stake in a regional venture.

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Jordan’s Arab Bank, the country’s largest lender, expects double digit profitability in 2013 as much lower provisions and steady growth in net operating income improved the bank’s bottom line.

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Daewoo Shipbuilding & Marine Engineering Co Ltd has won an 897 billion won ($796m) order to build oil production facilities in the Upper Zakum oil fields for the Zakum Development Company (ZADCO), a subsidiary of Abu Dhabi National Oil Company.

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