Health care system in Armenia: past, present and prospects

The paper describes the state and trends of health care, as well as the comprehensive reform program in Armenia. It presents previous, current situation and focuses on future development options. After demonstrating the logic of the investigation, the paper recapitulates the information about results of reform that do not appear to meet all the objectives of health care policy. The reform process has encountered resistance and there is now a serious risk that reformers may throw out the baby with the bath water. The most challenging problem that must be faced involves the drastic decrease in access even to the most essential health care services, as unlike many other transition countries, social-economic factors have prevented the implementation of medical insurance and generated a decrease in subsidized health services and visits for medical aid. Funding shortages often mean that even vulnerable groups have to pay. This has led to an increase of the length of illness and chronic pathology. Thus, the principle of equity with respect to financing and access is undermined. The paper indicates that disparity and polarization are quite high in the society. There are insufficient public funds and the highest share of informal payments prevents the poor to get adequate care. The paper describes the negative effects of widespread use of informal payments in health care and possible steps to reduce it. It analyzes topics such as, feasibility of state health insurance. The paper proposes to implement many interchangeable opportunities for learning in transitional countries and brings to attention the necessity to develop a mechanism for shared learning at the international level. These are outlined briefly at the end of the paper. The paper concludes and summarizes the range of recommendations which are most relevant to developing countries.