On 17 October 2015, one of the leaders of the United National Movement, Zurab Chiaberashvili, stated that the share of the state in overall healthcare expenses is just 25% (many are of the opinion that a hospital patient receives full funding from the state for healthcare costs). About 75% of healthcare expenses are paid by the patients themselves or their family members.

FactCheck

took interest in this statement and verified its accuracy.

According to the 2014-2020 State Concept of the Healthcare System of Georgia, one of the state’s main priorities is to increase the availability of medical services for the population and decrease the amount of money paid by the population for these services. The state planned to achieve this goal by increasing funding to the state healthcare sector and exercising the Universal Healthcare Programme.

A study on the use of healthcare services and associated costs (2014 data) was published in Georgia in 2015. The study, entitled Further Improvement of the Universal Coverage of Healthcare Services of Georgia, was conducted with the assistance of the World Health Organization (WHO), the United States Agency for International Development (USAID) and the World Bank. According to the study, the expenses of households on treatment, especially on incidences of hospitalisation, decreased in 2014. However, expenses increased somewhat for patients suffering from chronic diseases. In addition, expenses for medications increased within the poorest segment of the population and those living in rural areas. According to the study, expenses for medications dropped mainly for those in the upper and middle class strata of the population.

According to the aforementioned study, the amount of expenses paid by the patients themselves in 2013 constituted 62% of the overall healthcare expenses. This indicator has decreased as compared to the previous years (see Chart 1). The study underscores that it is necessary to "further lower the amount of personal healthcare expenses paid by the patients."

Chart 1:

Share (%) of Personal Expenses on Healthcare in Overall Expenses

Despite the fact that funding for the healthcare sector has increased significantly, personal expenses for healthcare services still remain among the greatest challenges for the system with the situation having worsened somewhat in certain cases (patients with chronic diseases, the population’s poorest and so on).

In order for the state to decrease personal healthcare expenses, whilst maintaining the principle of universality at the same time, a further increase of the funding geared towards the healthcare sector is necessary. This, however, is a serious difficulty given the current state of the country’s budget. The operation of the current Universal Healthcare Programme has already proved to be a challenge for the state which is confirmed by the Programme’s deficit (excessive spending) budget (see FactCheck’s article

on this topic).

According to the Assessment of the Fiscal Stability of the Universal Healthcare Programme in Georgia in the Period from 2015-2030, conducted by the PMC Research Centre and which is based upon World Bank data, the share of personal healthcare expenses in Georgia with regard to overall healthcare expenses was 62%. This indicator is about 55% in low-income countries whilst it is 29.5% in the developing countries of Europe and Central Asia.

We asked the authors of the aforementioned study to give us their opinions about what the state should have done to lower personal healthcare expenses, especially for vulnerable groups (the population’s poorest, low-income families and so on). According to their explanation: "In order to decrease personal healthcare expenses, state funding to the sector must increase even further. In addition, the Universal Healthcare Programme should incorporate expenses for medications as well. The co-financing system must also be reviewed and the issue of funding must be decided according to a patient’s income. State funding must be decreased in the relatively high-income stratum of the population with the money saved from this targeted towards increasing the funding of healthcare services for low-income families and the poorest part of the population."

Conclusion

According to the latest data, the share of personal healthcare expenses is 62% which is quite a high indicator. This is two times more than the indictors of developing countries of Europe and Central Asia. It also significantly surpasses the indicators of low-income countries.

As the studies confirm, the amount of personal healthcare expenses decreased after the enactment of the Universal Healthcare Programme; however, the situation worsened for highly vulnerable strata of the population. Personal healthcare expenses increased somewhat for patients with chronic diseases. In addition, the expenses for medications went up for the poorest part of the population and for those living in rural areas.

The number stated by Mr Chiaberashvili (75%) is incorrect; however, the context of his statement that patients have to cover most of their healthcare expenses from their own pocket is true.

Hence, FactCheck concludes that Zurab Chiaberashvili’s statement in MOSTLY TRUE.