Healthcare system in Georgia 1991-2016: achievements, problems and perspectives
After gaining independence, Healthcare reforms in Georgia can be divided into four periods:
- Period of inertia – 1991-1995 – During the soviet era (until 1991) Georgian healthcare system was the part of a global soviet healthcare system, so called “Semashko” centralized healthcare system.
After gaining independence, financing of healthcare system from the government was sharply diminished due to the economic crisis. The government could no longer provide its population with an adequate healthcare. The major health status indicators had worsened. Also many healthcare specialists left the country due to low wages and nonstable economic situation. As a result, a medicine in Georgia was on the brink of collapse.
- First stage of reforms – 1995-2003 – A process of reorienting Georgian healthcare system began on august 10, 1995. State’s obligations were determined by state’s healthcare programs.
Healthcare was decentralized. Social healthcare units were created in local governing bodies. Social healthcare programs were financed by public healthcare departments.
State medical units became private entities; as a result, their autonomy had increased. Also the law about ‘Healthcare management’ was created.
Reorienting the healthcare system made it possible to stop worsening of major health indicators.
Second stage of reforms – 2004-2012 –The main goal of the reform, started in 2006, was to develop market regulations. Existent universal programs were replaced with target group (poor population) oriented programs. Insurance companies got involved into administration of public health programs. As a result, insured people could have chosen preferred insurance companies. But, from 2010 the right of free choice was deprived and was changed to obligatory agreement with specific company. Plus, private insurance companies were obliged to build healthcare units in corresponding regions. As a result, a competition between insurance companies was
Third stage of reforms –from 2013 till now– In 2013, new major healthcare reform started, which introduced universal healthcare program (UHC) and covered the whole country.
In spite of 25 years of reforms, some problems still remain:
Developing primary healthcare. Primary healthcare in Georgia is still far from well-developed. Number of outpatient visits is 2.3 per person.
Ensuring high-quality healthcare services. There is still no system for quality control.
Increasing access to medications. The portion of expenditures on medications is high. One way to effectively lower prices on medications is to make all information about pharmaceuticals open and clear for everyone (prices and etc.)
Public-State Partnership Model. In Georgia there are only two forms of ownership of medical organizations: commercial and State healthcare units. Developing partnership between State and private sector will be beneficial for Georgia.
Sourse: Healthcare system in Georgia 1991-2016: achievements, problems and perspectives. Tengiz Verulava
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