Investments in health

According to the Minister of Health of Azerbaijan, Ogtay Shiraliyev, the obligatory medical insurance will be introduced by the end of the year. Usually, on the proverb, it is promised to wait for three years, but apparently not in this case. Already last week the Cabinet of Ministers of Azerbaijan approved the conception on reformation of financing health system and obligatory medical insurance. The plan of measures on financing of health system and introduction of obligatory medical insurance was also approved according to the order by the Cabinet of Ministers. The Ministry of Health of Azerbaijan, Government Agency on Medical Insurance at the Cabinet of Ministers of Azerbaijan and other relevant agencies are in charge of realizing measures, specified in the plan.

Thus, if by the end of this year there will be solved all organizational questions of introduction of obligatory medical insurance in the country, then already from the next year all citizens of Azerbaijan will possess medical policies and certain equal rights of access to the health services. In its essence, regardless of their sex, social situation and income level, the obligatory medical insurance must provide all citizens of our country with equal opportunities in obtaining certain level of medical aid.

The absence of obligatory service, which exist all over the world, in Azerbaijan has always caused regrets, in particular, when it was necessary for the foreign citizens, who arrived in the country for the realization of labor activity. Especially, arrival of the well-known British and American companies in the country within the framework of development of Azerbaijani fields caused demand for qualitative medical services. From the first days of their activity, the heads of the foreign companies introduced the system of obligatory medical insurance of their personnel and allocate significant funds for the labor safety and insurance.

Subsequently, some prestigious Azerbaijani companies also joined this practice. Local companies seemingly understand that the funds spent on the medical insurance of personnel are investments in the future and basis of steady development of business.

The introduction of obligatory medical insurance in Azerbaijan will contribute both to the development of insurance companies and medical institution. The practice of insurance companies, which render insurance services on the medical insurance, shows that the funds transferred by them to the private clinics increase the financial possibilities of the medical institutions to pay high wages. In many medical institutions there has been created material encouraging scheme from the reception of the insured patients, which makes doctors interested to render high level medical services.

Practically all insurance companies in Azerbaijan deal with medical insurance, but unfortunately, some of them now and then simply copy program products and do not have corresponding infrastructure for their realization. The companies, which deal with insurance medicine, must know all nuances of the health system, in which the key place must be provided to professional physicians, who have high organizational abilities as well. For the successful development of medical insurance, the insurance company needs to work at least three years in this segment.

Moreover the introduction of obligatory medical insurance is more complex task than the introduction of other forms of social insurance already acting in Azerbaijan. Indeed it is connected not simply with the provision of money payments, but with provision of corresponding social, more precise medical services, with the actual purchase of services in the corresponding producers and with rendering these services to the insured population.

With regards to the medical institutions, today mainly private clinics deal with rendering services on medical insurance. But the introduction of obligatory medical insurance in Azerbaijan will be connected with public medical institutions' joining this process. Earlier the Ministry of Health declared its non-preparedness for the application of obligatory medical insurance for the reason that Azerbaijan medical institutions lack technical base to render services for this class of insurance. But after 9 years from the day of adoption of Law on Obligatory Medical Insurance in 1999 in Azerbaijan there appeared many medical institutions, equipped with contemporary medical equipment, even in the regions.

But indeed the introduction of both obligatory and voluntary medical insurance for all persons will become the expression of the desire to obtain the more qualified medical services in the leading centers of the country. According to the plan of measures approved by the Cabinet of Ministers, the Ministry of Health and Ministry of Finance of Azerbaijan were in charge of estimating the existing situation in the health system, conducting monitoring of the system (financing first aid, hospitals, estimation of the condition of financial- technical base of health) by the end of the year. The Ministry of Health, Ministry of Finance, Ministry of Labor and Social Protection of Population of Azerbaijan are in charge of assessing the existing system of labor payment.

The experience of the majority of the countries of Central and East Europe, Central Asia, where this class of insurance is introduced, testifies that without the creation of the corresponding economic and political prerequisites in the society, the obligatory medical insurance can led to many problems. If the restructuring of the system of medical aid will not be carried out, relevant strategy will not be realized to increase the effectiveness of expenditures and rationalization of the use of the existing financial, material and technical and staff resources, the introduction of obligatory medical insurance can lead to undesirable consequences instead of the expected positive effect.

Significant deficit of the financial resources is also one of the main reasons for the difficult situation in the health system in Azerbaijan. The Parliament of Azerbaijan announced the results of the results of studies, according to which approximately 30% of expenditures for health are paid by State, 70% by citizens. Major part of the payment for the medical services does not have legal basis. And therefore, the aid (in form of credit) of the World Bank in the realization of project on the reformation of the health system in Azerbaijan appeared impossible for creating financial basin for the obligatory medical insurance and organizing a Fund for obligatory medical insurance.

The experts of the World Bank (WB) played a significant role in appearance of a new bill on obligatory medical insurance within a short period. Now already it is no secret that the old law in these years became obsolete and sequential changes should be made to it. In particular, the WB experts proposed forming a Fund for obligatory medical insurance. The State Social Protection Fund is ready to assume formation and control of the Obligatory Medical Insurance Fund. For its formation, it is proposed to decrease the transfers of legal entities to the Social Protection Fund from 22% to 20% in 2008 so that entire volume of decrease (2% of the wage fund) would be directed to the Obligatory Medical Insurance Fund. In this case, the amount of medical services on the obligatory medical insurance is estimated at$200mln.

At present the average payment of the annual medical insurance police of the private companies in Azerbaijan totals from AZN 150 to AZN 400. Medical insurance VIP costs AZN 800.

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