Armenia’s proposed comprehensive health insurance program aims to address critical gaps in the country’s healthcare system by ensuring equitable access to quality medical services. However, a detailed analysis of the draft legislation reveals structural challenges and risks that may undermine its successful implementation. The program envisions a single, state-managed entity, the Comprehensive Health Insurance Fund, to oversee the system without involving private insurance companies. While this centralized approach could streamline administration, it risks creating a monopolistic structure that may stifle innovation.
Financial sustainability is one of the primary concerns. The program plans to allocate 18 billion drams from the state budget in 2024, with funding rising to 4% of GDP by 2026. However, economic instability, unexpected healthcare costs, or increased demand for medical services could jeopardize these projections. The creation of a reserve fund is a positive step, but its capacity may be insufficient to address large-scale crises. The collection of insurance premiums from various sources—employers, direct payments, and state contributions—also presents logistical challenges. Ensuring that payments are fair and accurately managed is essential to avoid public dissatisfaction and financial inequities.
The program’s insurance package focuses on statistically significant diseases and healthcare needs. However, this approach excludes rare diseases and specialized treatments, potentially leaving certain groups without adequate coverage. This creates a risk of a two-tiered system, where wealthier individuals can access a broader range of services or rely on private providers. Rural areas may also face continued difficulties accessing quality healthcare due to shortages of medical staff and resources. These geographic disparities exacerbate existing inequalities, and the draft does not provide clear solutions to address them.
The proposed data management system, essential for the program’s effectiveness and transparency, carries its own risks. Ensuring the confidentiality and security of sensitive personal information is paramount. Any failures in data management could compromise the system’s functionality and public trust. While the legislation requires the publication of contracts with service providers, it does not include independent audit mechanisms or public oversight provisions. This lack of transparency could lead to inefficiencies and erode confidence in the system.
A notable provision in the draft requires persons with disabilities to undergo a functional assessment to determine their eligibility for coverage, except for those with permanent disabilities who may opt out. While this aims to identify their specific needs, it risks imposing additional burdens on already vulnerable groups.
Despite its ambitious goals, the proposed program is fraught with challenges that must be addressed for it to succeed. Financial sustainability, social equity, and system accountability are critical issues that require comprehensive solutions. The program’s success hinges on its ability to adapt to changing circumstances and ensure that its benefits reach all segments of the population.
Will this initiative transform Armenia’s healthcare system, or will it remain an unfulfilled aspiration? The answers depend on how effectively the program is managed and whether its implementation can overcome the outlined challenges.
The draft package can be reviewed at the following link.
Azat TV will continue to monitor the progress of this reform, offering impartial analysis and evidence-based evaluations.
