Access to Medicines within the State Health Insurance Program for Pension Age Population in Georgia (country)

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Access_to_Medicines_within_the_State_Health_Insurance_Program.pdf

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http://eprints.org/relation/isVersionOf http://eprints.iliauni.edu.ge/id/document/6350 http://eprints.org/relation/isVolatileVersionOf http://eprints.iliauni.edu.ge/id/document/6350 http://eprints.org/relation/issmallThumbnailVersionOf http://eprints.iliauni.edu.ge/id/document/6350 archive 128 disk0/00/00/15/55 2014-10-20 05:36:23 2014-10-20 05:36:23 2014-10-20 05:36:23 article 1543 no_search tengiz.verulava@iliauni.edu.ge Verulava Tengiz tengiz.verulava@iliauni.edu.ge ვერულავა თენგიზ tengiz.verulava@iliauni.edu.ge Access to Medicines within the State Health Insurance Program for Pension Age Population in Georgia (country) pub H1 RA RA0421 fac_bzn public Georgia; Health insurance; Catastrophic out-of-pocket payments; Healthcare; Financial access to healthcare; Pension age population. Pension age population and children belong to the largest risk group within insurance sphere. While the Georgia State Health Insurance Program for pension age population includes some compensation for medicines, medical insurance does not provide guarantee for financial accessibility to medical service. Healthcare for pensioners often represents catastrophic expenses and has become the major reason for their impoverishment. The most rapidly increasing and unaffordable share of health care expenses falls upon medicines. The annual limit for medicines defined by the state is low (100 GEL, with 50% co-payment). The majority of those interviewed (64%) have exceeded this limit by at least 50 GEL (about 28.5 USD). Almost 33% of the insured population cannot afford to buymedications prescribed by their doctors, highlighting low accessibility to medicines and the need for major changes to the insurance program. Universal insurance requires large amount of financial resources that represent heavy burden for low-income countries. State financing should concentrate on high-risk beneficiaries such as pensioners who are threatened by poverty and social inequities without this kind of support. It would be sensible to expand the insurance program for the above population groups and also provide more reasonable coverage of medication expenses. 2014 published HealthMED 8 9 Society for Development of Teaching and Business Processes in New Net Environment in B&H 1078-1082 TRUE 1840-2291 http://healthmed.ba/index.htm Berki, S. E. (1986). A look at catastrophic medical expenses and the poor. Health Affairs, 5(4), 138-145. Chanturidze, T., Ugulava, T., Durán, A., Ensor, T., & Richardson, E. (2009). Georgia: Health system review. Health Systems in Transition, 11(8), 1-116. European Commission. (Feb 2013). Access to medicines. Retrieved Jan 9, 2014, from http://ec.europa.eu/trade/policy/accessing-markets/intellectual-property/access-to-medicines/. Gamkrelidze, A., Atun, R., Gotsadze, G., & MacLehose, L. (2002). Health Care Systems in Transition: Georgia. European Observatory on Health Care Systems, 4(2), 1-72. Gotsadze, G., Zoidze, A., & Rukhadze, N. (2009). Household catastrophic health expenditure: evidence from Georgia and its policy implications. BMC Health Services Research, 9, 69-78. IOM. (Jun 2013). Country fact sheet - Georgia. International Organization for Migration. Geneva, Switzerland. Lomsadze, G. (Jun, 2008). Georgia Says Farewell to Public Healthcare. Retrieved 10 Feb, 2014, from http://www.eurasianet.org/departments/insight/articles/eav061908a.shtml. Ministry of Labour Health and Social Affairs of Georgia. (2013). Report on Evaluation Healthcare System Efficiency. Retrieved 3 Dec, 2013, from http://www.itdc.ge/index.php?lang_id=ENG&sec_id=3&info_id=299. Ministry of Labour Health and Social Affairs of Georgia. (Apr 2012). New insurance system has been accepted at the government’s meeting. Retrieved 12 Dec, 2013, from http://www.moh.gov.ge/index.php?lang_id=ENG&sec_id=29&info_id=981. Mondal, S., Kanjilal, B., Peters, D. H., & Lucas, H. (2010). Catastrophic out-of-pocket payment for health care and its impact on households: Experience from West Bengal, India. Institute of Health Management Research, India. National Statistics Service of Georgia. (2013). Quantity of Georgian population in accordance with age and gender. Retrieved 12 Jan,2014, from http://www.geostat.ge/?action=page&p_id=472&lang=geo. O’Donnell, O. (Mar 2008). Who pays for health care in Asia? Journal of Health Economics, 27(2), 460-475. Web of Science Rukhadze, T. (2013). An overview of the health care system in Georgia: expert recommendations in the context of predictive, preventive and personalised medicine. EPMA Journal, 4(1), 8-21. Social Service Agency. (2013a). State Health Insurance Program. Georgia. Retrieved Jan 18, 2014, from http://ssa.gov.ge/index.php?sec_id=36&lang_id=ENG. Social Service Agency. (2013b). Statistical data on the 2013 State Health Insurance Program: Georgia. Retrieved Jan 15, 2014, from http://ssa.gov.ge/index.php?lang_id=GEO&sec_id=771. UNDP. (2000). Human Development Report Georgia 2000. Tbilisi: United Nations Development Program. World Bank. (1999). Georgia - Poverty and income distribution (Vol. 1 of 2): Main Report (English).Poverty Reduction and Economic Management Unit, Europe and Central Asia Region. World Health Organization. (2012). Health System Financing Profile: Georgia. Retrieved 12 Jan, 2014, from http://apps.who.int/nha/database/StandardReport.aspx?ID=REPORT_COUNTRY_PROFILE. World Health Organization. (2014). Essential Medicines and Health Products Information Portal. World Health Organization, Geneva. Retrieved Dec 14, 2013, from http://apps.who.int/medicinedocs/en/d/Js6160e/7.html. World Health Organization. (May 2013). Georgia - Country Cooperation Strategy. World Health Organization, Geneva. Retrieved 6 Dec, 2013, from http://www.who.int/countryfocus/cooperation_strategy/ccsbrief_geo_en.pdf. World Health Organization. (Oct 2012). What is universal health coverage? Retrieved 12 Mar, 2014, from http://www.who.int/features/qa/universal_health_coverage/en/. Wyszewianski, L. (1986). Financially catastrophic and high-cost cases: definitions, distinctions, and their implications for policy formulation. Inquiry, 23(4), 382-394. Web of Science Xu, K., Evans, D. B., Carrin, G., Aguilar-Rivera, A. M., Musgrove, P., & Evans, T. (Jul 2007). Protecting Households From Catastrophic Health Spending. Health Affairs, 26(4), 972-983. Web of Science