The FINANCIAL — The personal cost of health care is quite high in Georgia, especially when comparing per-visit costs to per capita GDP.
However, the country is not alone in their predicament, asMoldovans, Armenians, and Ukrainians are all paying a lot out-of-pocket. Russians and Belarusians, on the other hand,payconsiderably less.
In 2010, Georgian Opinion Research Business International conducted a poll in several countries that are still in transition from the Soviet Union. Among a variety of public health related questions in the poll, we asked respondents who had recently received healthcare services to estimate how much they paid for a variety of services. Included in the expenses that were tracked were transportation, consultation, treatment, and consumables (drugs). Additionally, we asked whether these payments were formal or informal, which wasdescribed to respondents as “any unofficial payment to a doctor or any other staff member, including gifts, without receiving a receipt.”
The results of this poll match expectations in some areas, and surprise in others.
Consultation |
Treatment |
Drugs |
Total Visit |
GDP (PPP) |
Cost/ GDP |
|
Armenia |
$19.13 |
$58.73 |
$41.90 |
$155.95 |
$5,300 |
2.94% |
Informal |
$3.28 |
$8.96 |
$0.78 |
|||
Belarus |
$2.26 |
$7.54 |
$16.62 |
$37.32 |
$14,300 |
0.26% |
Informal |
$0.32 |
$9.83 |
$0.00 |
|||
$19.60 |
$39.77 |
$55.46 |
$107.89 |
$5,300 |
2.04% |
|
Informal |
$1.69 |
$0.69 |
$0.05 |
|||
Moldova |
$7.86 |
$28.10 |
$33.38 |
$107.45 |
$3,200 |
3.36% |
Informal |
$4.62 |
$4.30 |
$0.19 |
|||
Russia |
$11.66 |
$8.11 |
$30.88 |
$55.86 |
$16,300 |
0.34% |
Informal |
$3.44 |
$0.46 |
$0.61 |
|||
$15.85 |
$43.92 |
$39.66 |
$127.81 |
$7,000 |
1.83% |
|
Informal |
$8.36 |
$8.39 |
$2.56 |
In a country with an extensive public health insurance program, Russia, costs were much lower relative to GDP than other countries with no general public health insurance. On the other hand, Georgia and Armenia have no state-provided health insurance for their general public and costs are much higher. This seems to make a lot of sense: if you have insurance, you should be paying less.
Russians were nearly universally covered by their national health program, 90% rely on it exclusively. The total average cost for Russians’ recent trips to the hospital was just over $55 US. Conversely, Georgians and Moldovans paid more than $107 per visit, Ukrainians $127, and Armenians a whopping $155. This contrast is even more stark when we calculate these total average costs relative to each country’s per capita GDP. Russians enjoy health care visits that are about a third of a percent of their per capita GDP. Georgians spend 2% on average and Armenians a full 3% of their total portion of GDP.
This all seems to match the idea of a national health care correlation to low costs. Unfortunately, there’s one big reason we can discount the idea that national insurance coverage is a determinative factor in out-of-pocket expenses. Standing completely outside our expectations is Moldova. 70% of the country is on a national health insurance plan, but they pay the most per visit: 3.4%.
While it seems that individual health care costs are notdirectly related to the portion of the population that is insured, you’d be surprised to know that whether you’re insured or not doesn’t seem to be decisive for personal costs at all. Rather, it’s the health care system you’re using. Some privately insured patients in Georgia are actually paying more out-of-pocket than completely uninsured in other countries. Next week we will discuss this apparent inconsistency more extensively, and consider insurance coverage and cost distribution of services.
All costs were recorded in respondents’ own currency, and converted after the fact into US dollars using exchange rates from the time of fieldwork. All per capita GDPs are calculated using purchasing power parity.
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