TBILISI, DFWatch – A new report by Transparency International Georgia (TI) shows that the country’s health insurance system has major flaws.
The study shows that there are mistakes when lists of beneficiaries of insurance programs are being worked out.
The government will spend 174,1 million lari on the insurance system in 2012. But the study shows that the government is failing to calculate the cost of insurance programs, which creates problems later on.
In addition, there is no health care quality assurance and monitoring system.
The report also notes that the State Audit Service has found names of the same people listed twice, as well as dead people listed as insured.
The result of these errors is a massive waste of money — the government has lost over one million lari, or about USD 600 000, TI estimates.
Among those who benefit from the state insurance system, 20% have salaries above 300-400 lari, which means that they should not be beneficiaries of the insurance system at all.
The study also focuses on another problem: a significant part of Georgia’s hospitals are managed by insurance companies or their subsidiaries, and not by independent companies.
TI presented a study on this subject in July, which showed that three pharmaceutical companies, controlling almost the entire Georgian pharmaceutical market are trying to be leaders on the insurance market too.
But the study is not only pointing out areas of government waste. It also shows that those who receive state insurance are unable to buy medication at a vendor of their own choosing.
The survey showed that the insurance company Alpha, which is a subsidiary of the pharmaceutical company Aversi, is making beneficiaries buy medication only in Aversi outlets.
Having identified areas of concern, TI also made the recommendation that hospitals should be managed by independent companies, not insurance companies or their subsidiaries.