Iobidze M, Chikhladze N,

Loria L

The

State Health

Insurance In

Georgia

სადაზღვევო ბაზრის შემოსავლის წყაროები:

საქართველოს სადაზღვევო

ბაზარი

კერძო დაზღვევის

სახეები

სახელმწოფო სადაზღვევო პროგრამები

სადაზღვევო ბაზრის შემოსავლის წყაროები:

Georgian Insurance

Market

Private Insuranc

e

State Insuran

ce Progra

m

Since 2007 the Government of Georgia took

the responsibility to purchase insurance

package from the private companies for its poor

citizens and for the certain categories of the

public servants, such as teachers, employers of

military forces and the Ministry of Internal

Affairs.

Since 2010, there were held tenders, as a

result different private insurance companies

serving different regions of the State

problems

The poor quality of medical services Interpretatio

n of coverage and exceptions in

favor of insurance company

neglecting to

subsidize of some

specific diseases

Choose of the private

insurance

company

False promise of compensati

on

getting the medical

services in desired hospital

(წყარო: PSI საზოგადოებრივი განხილვები ჯანმრთელობს დაცვა და სოციალური)

Research was conducted in Imereti, where the most of

the people are insured by the State insurance program.

(61 142 family, 181 218 people, 2011 year).

Research object:

Research was conducted in Imereti region to find out the

awareness level of the the vulnerable citizens and

teachers on insurance system and medical services, also their rights and procedural issues, within the State insurance program. . Using random sampling

method I made inquiries more than 280 vulnerable citizens and teachers from Kutaisi,

Bagdati, Vani and Tskaltubo. On base of research I made

some conclusions and references.

No74%

yes26%

No37%

yes63%

vulnerable citizens teachers

Did you choose the insurance company yourself?

Quality service25%

Insurance package

3%

Unquali-fied personal48%

other24%

Quality service33%

Insurance package23%

Unquali-fied

personal.

19%

other25%

vulnerable citizens teachers

What don’t you like in your insurance company and

what you would improve?

Other:Need a run to get finance; The right to visit on desired doctor.;Dentist serviceTo compensate all kinds of analysis.

yes43%

No57%

yes77%

No23%

vulnerable citizens teacher

Did you read the insurance contract during the insurance proceedings?

Did you get whole information what kind of medical services

you can get within your insurance contract?

yes No part.0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

25% 26%

49%

yes No part0%

10%

20%

30%

40%

50%

60%

70%

63%

14%23%

vulnerable citizens teacher

Are you informed, where you can get medical services within your insurance

contract?

partially 45%

Yes40%

No15%

yes 65%

No14%

partially 21%

vulnerable citizens teacher

Do you know where you need to call to get an additional

information?

Yes62%

No14%

partially 24%

yes65%

No11%

partially24%

vulnerable citizensteacher

Are there any facts to refrain from an insurance reimbursement?

yes25%

No75%

yes29%

No71%

teachervulnerable citizens

Does the acceptance of the insurance policy make

available to get medical care?

yes No part. didn't use0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

43%

0%

22%

35%

yes no part. didn't use0%

10%

20%

30%

40%

50%

60%

53%

17%19%

11%

vulnerable citizens teacher

Is your policy enough to get preferred medical service?

0.65

0.35

yes Nodidn't use

64%

25%

11%

yes NoDidn't use

vulnerable citizens teacher

Do you like the quality of the medical services in hospitals?

yes40%

No25%

Didn’t use35%

yes65%

No24%

Didn’t use11%

vulnerable citizens teacher

Will you change something in your insurance package?

yes43%

No57%

yes39%

No61%

vulnerable citizens teacher

Visit to desired doctor;get the desired medicine;

service of dentist; To compensate all kinds of analysis;

To explain better the privilege of policy;“To simplify the insurance proceedings, otherwise healthy man

will become ill !!!

Yes:

C o n c l u s i o n:The most of beneficiaries know the hospitals where

they can get the medical service, but they are

displeased, because they want to get medical service in

other hospitals.

The most of beneficiaries said that the insurance

policy made the medical service more available. But

they had the facts that company didn’t compensate the

service.

They are not satisfied with the quality of services and

the professional skills of the employees' of insurance

companies

The majority know what kind of medical services they

can get within the insurance package, but they are

dissatisfied with the fact that insurance companies do

not reimburse specific diseases.

Recommendations:

It is necessary to improve population awareness of the broad masses and service quality of the

insurance companies;

Inform the insured population how to utilize the services;

Allow people to choose the insurance provider;

Make clear definition of the provisions, including the rights of the insured citizens, in the insurance

contracts.

Thanks for your attention!!!