The "Fact" daily writes:
The healthcare system of Armenia, as a key component of the state's viability and health guarantees, is ahead of years of structural, systemic and socio-economic complications, which are mainly due to the ineffectiveness of reforms, financial vulnerability and the lack of state policy.
The RA Health Financing System, compared to many European and Asia countries, has low state funding.
Over the past 25 years, health expenditures amounted to only 1.4 percent of GDP, which is significantly lower than the global average, especially since the level of universal health care or at least systemic accessibility.
And since the volume of funding is not enough to meet the population, most of the citizens face financial obstacles to receive medical care.
This means that the main burden of medical expenses continues to be on the shoulders of citizens, which deepens social inequality, the marginalization of vulnerable layers and the common practice of refusing medical services.
It also contributes to the fact that many citizens, taking into account the high prices of medical services, avoid medical tests and research to the moment when the knife reaches the bone.
At the same time, there is a crisis in the healthcare sector. There are many complaints about corruption schemes, non-transparent competitions, unjustified budgetary spending and exaggerated and ignored health institutions.
And the problems in this direction have been rooted that certain areas of health have become just spheres of money, and there is no interest in providing quality services to the population.
At the same time, issues of public medical institutions are raised such as the low level of doctors' salaries, the antiquity of medical equipment, lack of precinct doctors and the deformation of the first aid network. There is a personnel crisis in almost all regional medical institutions, as young professionals are mainly focused on the ability to work in Yerevan for high pay and private sector. Hospitals operating in the regions are often only formal, without the necessary technical and professional potential.
It is necessary to emphasize the lack of a mandatory health insurance system, which has been discussed many times, but has never been introduced in a systemic and complete way. The idea of public health insurance remains in software documents, while the majority of the population continues to spend its own funds on medical care, and with state support services are limited to the minimum social package, which is impossible to solve any health problems.
This leads to the fact that some diseases are not found in the early stages, and in the event of serious complications, the cost of treatment is becoming very large for the state's most vulnerable areas of the medication. The high level of drug prices compared to regional and even European countries is a disproportionate heavy burden for the population. Many pharmacies are sold, due to both monopoly import schemes, both weak state control, both customs and tax barriers. There are no clear mechanisms for the regulation of drug prices, promotion of competition, as well as the restriction of super profits.
The drug market is also frequent when the same drug is imported by different manufacturers at different prices, without quality difference, which testifies to the non-transparent price mechanisms. On the other hand, the pharmaceutical sector in Armenia is not developed. 92% of medicines are imported, only 8% are produced in Armenia. Meanwhile, the field of drug production could also create new economic opportunities for Armenia and become a new direction of export. One of the drug registration and control system is not enough.
There are still cases when Armenia is imported to Armenia, or even those who are banned in other countries for use. And it is especially worrying that recently, information on the import of drugs that lead to dangerous consequences are circulating in the press. In this context, it is necessary to mention the uncontrolled circulation of biological active additives. The funds are common in the market, which are presented as a healing, but do not have a corresponding evidence of clinical or laboratory tests and are not controlled by the state. In such an environment, citizens are often lost, believing in advertising promises and jeopardizing their health.
Although some steps have been taken to introduce a healthcare system, most doctors continue to work in paper, and patient's medical historics are not complete, distributed in different institutions and are unavailable from a universal point of view. This makes it difficult for effective medical planning and preventive measures. In the context of digital health, it is necessary to initiate the creation of mechanisms in which the emphasis on the protection and information security of the citizens' health.
On the other hand, the healthcare is lacking prevention-based approach. Early diseases are mainly formal, the regular inspection system is incomplete, and the programs aimed at forming a healthy lifestyle in society have a slight impact. Distrust of medical services is also common, especially in state institutions. Many citizens prefer to apply to private clinics, paying more money, only not to be ignored with indifference, unserious approach, unreliable diagnosis or ill-treatment.
And in cases where a citizen does not have a financial opportunity to apply for private medical care, it is often reconciled to illness or resorts to self-healing. This is a direct threat to public health, as incorrect treatment leads to complications, chronic diseases, and ultimately, there are also serious gaps in training and professional qualification. Many doctors do not participate in training courses or modernization programs for years, as the system does not provide adequate stimulus mechanisms. On the other hand, doctors are not motivated to engage in self-education and studying professional literature when global medicine makes a lot of progress, and new treatment methods are found.
When considering all these issues, it becomes clear that Armenia's healthcare needs serious reforms, comprehensive and coordinated approach. Healthcare should not only be seen as a social spending or social assistance, but as a strategic direction of national security and the country's development. Without a healthy society, no educational system and no political transformation cannot be stable.
And a healthy society is possible only when the citizen trusts the healthcare system, can get accessible and qualified medical care, and the state turns that trust in responsible policy.
Arthur Karapetyan
