The FINANCIAL — Patients diagnosed with serious or rare diseases who are unable to get treatment in Georgia find it extremely hard to go overseas to get treated for two reasons: on the one hand the cost of medical treatment abroad goes way beyond that in Georgia; and on the other – even if they have a full health insurance package, the latter still doesn’t provide for a patient’s overseas treatment if required.
Two leading insurance companies contacted by The FINANCIAL, Aldagi BCI and GPI Holding, say that such healthcare plans do not exist. Tinatin Stambolishvili, head of the PR division at GPI Holding explained, “Our individual health insurance plans do not include potential treatment in foreign clinics whilst when it comes to large organizations like the US Embassy or consulate offices such insurance plans do exist though the costs are very high”. That’s to say, in other words “He who pays the piper calls the tune”.
George Lolashvili, President of the Georgian Insurance Institute, explains that such packages comprise less than 0.5% of the whole insurance market and are only for V.I.P clients whose annual premiums go up to 3,000 GEL.
He also clarified that “sometimes patients want to get insured against such eventualities but companies mostly don’t offer such insurance packages and even if they do offer them – the price that clients would have to pay is prohibitively high.”
To look at the issue from another angle, what can a patient actually do if they encounter such a situation in Georgia? There is a solution but the financial burden it involves is almost too much.
There are five companies established in Georgia solely for the purpose of advising such patients and sending them to foreign clinics for various therapies.
The fact is that the main way of covering those expenses is out-of-pocket payments. Neither Georgian nor foreign insurance companies provide support for them. Thus either organizations (who help people with certain diseases) provide financial support, or the patients have to find the resources themselves, the latter being the reason why we see so much evidence of people asking for help via media means such as Facebook, posters and sometimes even the television.
Globalmed, one such company, said that the patients they see who are looking to go abroad comprise people of all ages suffering from serious health conditions.
The costs of service at Globalmed go up to 700 EUR. When it comes to examination of a patient in Germany for example, involving consultations with professors and prescriptions – the total cost ranges between 2,000-5,000 EUR. In the case of surgery the price depends on the specific disease.
“Patients coming to GlobalMed want access to go such innovative medical procedures which are currently not available in Georgia,” said Gocha Tsinstadze, General Director at Globalmed.
“The most popular destinations for such patients are Israel, Turkey, the USA, Germany and Japan. But it also depends on what kind of disease is involved. For example in regards to diagnostics, patients are usually directed to Germany; in regards to cancer – they’re sent to Japan, Israel or Germany; whilst regarding children’s diseases patients are usually advised to go to the US,” said Tsintsadze.
“There is also a separate group of people who are in need of an organ transplant – heart, liver etc. In this case they are advised that they can travel to India as well as the abovementioned countries,” said Tsintsadze.
“Our number of patients is significantly increasing due to the fact that we not only send patients abroad but with us patients can get distance diagnoses through the help of online consultations with the relevant doctors abroad,” explained Tsintsadze.
The current insurance situation in Georgia
There are at the moment about 1.5 million insured people in Georgia, out of which roughly 900,000 remain on insurance policies provided by the Government.
Four years ago this figure was only 40,000 people, according to the Ministry of Labour, Health and Social Affairs.
Nowadays roughly 3 million people remain uninsured in the country.
Starting from 2007, the vast majority of outpatient clinics and hospitals changed from public to private ownership under new hospitalization reform, leading to reconstruction or in many cases the building of new hospitals (100 in total). Those hospitals are under the ownership of insurance companies.
The reason the Government started the reform was erratic financing from the state budget, and poor planning and administration of payroll tax revenues which contributed to the accumulation of debt to providers and impeded financial stability of healthcare providers and healthcare financing in general.
According to Andrew Urushadze, the Minister of Labour, Health and Social Affairs, it is planned that by 2015 there will be 2.5 million people covered by insurance in Georgia.
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