Three lari for the health of the nation18.02.2009 | 10:04
Georgia's President Mikheil Saakashvili proposed a new system of health insurance in his recent speech to parliament. Admittedly, this initiative came about two months later than it was meant to, because from the beginning of the year the free service for almost all categories of citizens was stopped. Both patients and doctors are suffering.
"In Georgia there are two systems of health insurance: an expensive one and a free one," the media quoted Mikheil Saakashvili. The former is only available to the rich, the latter for those who eke out an existence below the poverty line. Most Georgians end up outside these two systems. And since the New Year, Saakashvili forgot to add, the poor have had their privileges taken away from them.
In order to give medicine back to the people, the president proposed introducing a medical insurance programme financed in part from the budget. The way it would work is that citizens buy a package of medical services of up to 8000 lari by contributing just 1.75 lari a month. The state would supplement this payment by adding a further 3.25 lari.
The first opinions of insurance companies about the president's proposal have already emerged. As the internet publication "Business Georgia" reported, representatives of GPI Holding consider it realistic to introduce insurance of 5 lari per individual, although they have not yet acquainted themselves in detail with the programme. Aldagi BCI said that they started working on this plan alongside the government. Gizo Tsagareishvili, the director general of "National Insurance", noted that the package of services worth up to 8000 lari does not include dental care and will not be able to solve all problems.
Trade unions, deputies and non-parliamentary politicians have been trumpeting the need for state participation in the health insurance system for a long time. The abolition of a free medical service threatens to result in a social explosion. After all, even children and patients in infectious diseases units and oncological wards now have to buy policies. Moreover, probably because of the crisis, insurance companies are stopping transferring funds to medical institutions. Therefore, in January health centres refused to treat some patients because of the debts accrued by the "IRAO" company, which the Labour party accused in January of appropriating 140 million lari (about $90 million) from the budget that was meant to provide insurance for the poorest citizens. "IRAO" is incidentally headed by Mikheil Saakashvili's brother. Clinics in Batumi closed their doors to clients insured by Aldagi BCI and Archimedes Global Georgia, also because of these companies' debts. However, a survey carried out by the newspaper Kviris palitra showed that only 10.8 percent of respondents actually used insurers.
In early February, Georgian trade unions spoke out at a rally in support of expanding social safeguards, including the reintroduction of free medical treatment. As Archil Djakeli, a spokesman for the Trade Union of Medics, explained to the newspaper Rezonansi, the health care reforms have had lamentable results: "Medical staff in health centres have been put in an extremely difficult situation because it is impossible to support yourself in these conditions." According to him, casualty departments do not know what to do either, especially when the victims have no insurance and no money.
At the same time, the Kommersant radio station website published the results of a survey which showed that most Georgians are unhappy with the medical treatment available to them. This assessment is surprising, considering that over the five years between 2003 and 2008, money flowed into the country for modernizing the grass-roots health service.
As well as grants from abroad, the reforms to the medical sector comprised a substantial share of Georgia's own budget and domestic investment. Discounted leases and the cheap privatisation of state medical institutions served as incentives to build private clinics. By 2010 the entire health-care system, according to the plans put forward by the Health Ministry and the Ministry for Economic Development, was meant to have been taken over by private companies.
At the same time, in 2006 the "Programme for free grass-roots healthcare" was launched. Vladimir Chipashvili, the Minister for Labour, Health and Social Affairs, as the Regnum agency reported, promised: "In the near future the programme will encompass all the inhabitants of Georgia - irrespective of their financial means." Treatment at health centres was expected to become absolutely free as early as in 2008.
But 2009 arrived, and the country's authorities have decided to completely abandon their social commitments in the health sector. Georgians have lost any right to free medical help. The president's innovations in the medical sector have shown once again that the ruling elite is far from understanding the needs of the people and does not listen to their demands.