Giorgi Vashadze, Member of the Parliamentary Minority, stated at the plenary session held on 29 May 2013: "The ridiculous health insurance which you, the new government came up with, does not actually cover anything. It does not even cover bandaging a wound. Just two medical tests are included in this health insurance. People are in very difficult condition."
The Universal Healthcare Programme was launched on 28 February 2013. Universal Healthcare insures all citizens of Georgia aged 6-60 who did not have any type of insurance before. In order to obtain the abovementioned insurance, the following procedure is required: citizens choose the desired polyclinics involved in the programme and confirm by signing that they want to receive their regular outpatient services in this particular polyclinic.FactCheck
wondered what types of services are offered to the beneficiaries of the Universal Healthcare Programme. We checked the accuracy of the statement made by Giorgi Vashadze.
Beneficiaries of the state-sponsored Universal Healthcare Programme receive the following minimal medical services free-of-charge:
- Consultation with a family or district doctor, obtaining a health certificate, provision of prophylactic vaccination; provision of services at home when necessary, laboratory tests with express-diagnostic method: urine test and blood glucose, electrocardiography when necessary;
- Clinical-laboratory tests prescribed by a doctor: general blood test and general urine test;
- The insurance provides unlimited funding of emergency outpatient (medical) service when necessary;
- Emergency inpatient services (hospitalisation). In the case of hospitalisation, the limit is GEL 15,000.
A patient would not be able to receive emergency medical service in a hospital which has not confirmed its inclusion in the abovementioned programme in written form.
Resolution 36 of the Georgian Government adopted on 21 February 2013 determines the outpatient and inpatient services covered by the Universal Healthcare Programme. According to the abovementioned Resolution, a patient cannot receive such a medical service which is not included in the list of diseases determined by Resolution 36.
It should be noted that the insurance does not cover regular outpatient medical services and medications.
We contacted the hotline operator of the Ministry of Labour, Health and Social Affairs of Georgia. According to the explanation provided by the hotline operator, the second phase of the Universal Healthcare Programme will be launched from 1 July 2013 and regular outpatient medical service will be added to the insurance package.Conclusion
At this stage, the Universal Healthcare Programme insurance package covers only minimal outpatient service and emergency medical service. It also covers emergency inpatient services. However, the types of diseases covered by the insurance are determined in advance.
It should be noted that a patient can receive the abovementioned medical service only at those polyclinics which are included in the Universal Healthcare Programme.The state-sponsored Universal Healthcare Programme is not comprehensive. However, it partially covers outpatient as well as emergency medical services. Accordingly, we rate the statement by Giorgi Vashadze: “The insurance does not actually cover anything but only two medical tests,” MOSTLY FALSE.