The FINANCIAL -- There is no up-to-date general assessment of the performance of the Georgian healthcare system; the current expertise in healthcare programmes, including what is financed by the state and what is not covered. The most recent report of the World Health Organization made about the Georgian healthcare system was issued back in 2009. Since that time WHO has been counting on reports by the local Ministry of Health.
The health status of the population, the quality of healthcare services and healthcare outcomes, health promotion and disease prevention policies, access to healthcare services, and the efficiency and effectiveness of healthcare services are the main topics which have not been investigated since 2009. The latest report does not contain information regarding the absence of programmes. It does not evaluate concrete programmes at all. There is no data on the situations in hospitals and clinics.
“The State Healthcare Insurance Programme has failed in Georgia due to the ineffective management of the insurance companies involved,” The FINANCIAL wrote last week.
Healthcare insurance is a nightmare for many patients in the country with health problems. A long queue of patients waiting many hours to be seen by doctors is a common sight in both old and renovated clinics. Most of them are elderly people, who are using State Insurance, often called Pensioners Insurance, or the Universal Healthcare Programme also known as Universal Insurance. Such patients are not welcome in many places, they are not respected nor served the same way as those that have private insurance.
There is an endless list of people in Georgia who pay for medical treatment from their own pocket and are falling below the poverty line as a result. Popular social networks are now getting filled with urgent requests for fundraising for people with leukaemia. Insurance companies do not cover the treatment of such diseases. The Government provides very limited financial assistance to such patients, while surgeries are not financed at all.
The World Health Organization is currently evaluating the Universal Healthcare Program. The results are expected to be announced in March.
When asked why WHO does not monitor the healthcare system in Georgia or how reliable it is to use the information that the local Ministry of Health provides, Rusudan Klimiashvili, head of the WHO Georgia office, answers that WHO has to trust the Ministry of Health because it does not have enough resources to monitor the healthcare system in Georgia itself.
“WHO lacks the resources to work independently in Georgia,” said Klimiashvili. “We have to trust the information which the Ministry of Health gives us, otherwise we have to monitor the whole healthcare system in Georgia, which requires huge resources which WHO simply does not have at this time. WHO signs a two year contract with the Georgian Government and evaluates only the programmes that the Georgian Government needs to be evaluated. At this time, WHO is working on the Universal HealthCare System and the report will be ready for March 2014. WHO Europe experts will be visiting Georgia for an assessment of the healthcare system’s developments,” she added.
Despite the fact that the World Health Organization doesn’t assess the general performance of the Georgian healthcare system, it still says that Georgia is making good progress in this direction.
“WHO does constantly monitor the situation in the Georgian healthcare sector,” Liuba Negru, Corporate Communications at WHO Regional Office for Europe, told The FINANCIAL. “This means that our experts help to assess, analyze and advise Georgian health authorities on public health matters. Our experts believe that Georgia is making good progress in developing its health sector. WHO has and will continue to help the country in building up a good healthcare system that can deliver quality services to all people,” said Negru.
“When it comes to the WHO assessment reports, they don’t aim at ranking or telling the country what to do. Those reports are tools that WHO develops to help national health authorities have a clear and objective picture of the situation, which should help them take the right decisions. There are no specific time intervals for the reports. It is up to the team of experts and the national partners to decide when a new review is required,” she added.
As WHO Regional Office for Europe explains, the configuration of healthcare systems varies from country to country. “There is no such thing as a ‘perfect’ or standard healthcare system. But, in all cases, a strong healthcare system requires a robust financing mechanism; a well-trained and adequately paid workforce; reliable information on which to base decisions and policies; and well maintained facilities and logistics to deliver quality medicines and technologies. Georgia has and continues to make good progress in these directions,” said Liuba Negru.
Georgia Red Cross Society is not providing reports about the medical service or related topics either, according to Nino Osephashvili, MD, Health and Care Department at Georgia Red Cross Society.
The World Bank recently conducted research about the pensions system, which says that the profound effects of aging populations and a shrinking labour force on overstretched state pension schemes in Europe and Central Asian countries demand urgent reforms. If bold pension reforms are not made, it will be today’s young and the elderly poor who will suffer the most from the inability of state pension systems to ensure basic income protection in old-age. Failing to act today raises equity concerns for the next generation as it would likely result in future pension benefits cuts and these would hurt the poor more than the rich, according to the report.
“The countries of Europe and Central Asia have been some of the most active reformers in the world, adopting a number of new pension designs, such as point systems in Serbia and Croatia, notional accounts in Latvia and Poland, universal benefits in Georgia, Kazakhstan, and Kosovo, and individual savings accounts in Estonia, Romania, F.Y.R. Macedonia, and the Russian Federation,” said Laura Tuck, World Bank Vice President for Europe and Central Asia. “However, many of these reforms have not been sufficient for pension systems to sustain adequate benefit levels in the face of deep demographic changes. Moreover, some of these reforms have been reversed in the face of short-term fiscal pressures,” Tuck added.