According to official information, the population officially registered in the cities of Baku and Sumgayit, as well as in the Absheron region, will use 2,550 medical services from April 1, already included in the package of compulsory health insurance services.
What services will the population be able to use? How will the system work? Will every citizen be able to use the medical services included in the package of services at the expense of insurance? Will doctors’ salaries meet their needs?
A resident of the Yevlakh region told Radio Azadlig that although the compulsory health insurance fee is deducted from wages, it is useless. “Previously, we only paid for the doctor, now we pay for the insurance and the doctor. And the quality of service is zero.”
And some doctors are not very happy with the compulsory health insurance system.
E.T. told Azadlig Radio that the doctors’ salaries are unsatisfactory. “The doctors were assigned humiliating salaries. The doctor receives the same salary as the orderly. For an operation costing 1,500 manats, the surgeon will be given a bonus of 150 manats. Firstly, not every surgeon can perform this operation, and secondly, how long will the surgeon who can do this work for this bonus? ”
The doctor added that the system needs to be adjusted, otherwise the system will not work. “There is a surgeon in the Jalilabad diagnostic center. He received a salary of 46 manats. Many doctors are in this position. That is why most specialists leave the public hospital and take jobs in private clinics. In the field of therapy, at best, they give a bonus of 200 manats. If the salary does not change, the situation will worsen. ”
As Turan was told in the State Agency for Compulsory Health Insurance, an annual fee for compulsory health insurance is allocated for all citizens at the expense of the state budget.
“Persons who do not work anywhere under an employment or civil law contract, as well as who are not engaged in entrepreneurial activity, are exempted from paying contributions to compulsory health insurance until January 1, 2024. At the expense of the state budget, they can use 2550 medical services included in the package compulsory health insurance services, ”the agency said.
The ministry stressed that the list of services includes primary health care services, emergency and urgent medical care, specialized outpatient care, laboratory, physiotherapy, invasive radiology and inpatient medical services: “All medical services included in the package of services are provided to the citizens of Azerbaijan free of charge. Medical services under compulsory health insurance are provided in medical institutions run by TABIB. If it is impossible to provide any of the medical services included in the package of services in public medical institutions, the citizen is given the opportunity to receive these medical services in private medical institutions that have an agreement with the Agency.”
The agency noted that in order to use the Package of Services, citizens due to health problems must first of all consult a family doctor, with the exception of emergency and urgent medical care. The family doctor directs a citizen to a qualified doctor if he needs qualified medical assistance after examination or treatment. When contacting a medical institution on the basis of a referral, it is necessary to present an identity card to the registrar.
The department reported that the monthly official salary of health workers is determined by 18 degrees on the basis of a unified tariff guide, taking into account the length of service and the assessment of performance. In addition, there are fixed or incentive service premiums for physicians.
The agency stressed that doctors working in the surgical department, maternity department of gynecology, are paid a bonus of 20% of the amount accrued after deducting administrative costs from the approved tariff for medical services. For example, the cost of an operation to remove a foreign body from the stomach is 500 manats excluding VAT. The agency pays the medical institution that carried out this operation 590 manats, including 18 percent VAT. The remuneration of the doctor who performed the operation is calculated as follows: about 30 percent of medical expenses are deducted from 500 manat, which leaves 350 manat. Out of 350 manats, 20 percent for a doctor will amount to about 70 manats.
The agency noted that a group of medical workers is paid monthly 15 percent of the official salary for dangerous and difficult working conditions, 20 percent of the official salary for especially dangerous and especially difficult working conditions, and for working conditions associated with human immunodeficiency syndrome or the immunodeficiency virus person – 60 percent of the official salary.
Physicians who work remotely from their place of residence in rural areas and localities and who receive a fixed incentive bonus are also paid a fixed bonus.
The department added that doctors involved in work at night, and these are surgeons, resuscitators, obstetricians and gynecologists, ambulance workers are paid a surcharge of 50 percent of the hourly wages for every hour of work performed at night, and other workers -35 percent of salary.
Expert economist Azer Mehdiyev told Radio Azadlig, although it was assumed that the introduction of health insurance across the country would happen in 2019, this only happened on April 1, 2021.
The expert believes that the credibility of the CHI system depends on the level at which it provides medical services to the population.
“On the other hand, there is such a question as protecting the rights of patients. Now it is like this – the patient goes to see a doctor, the doctor prescribes examinations, medications, the patient does not know how necessary it is. But if the treatment is ineffective when applying health insurance, then questions may arise to the doctor, and payment can be made only if the treatment is justified,” he said.
According to Azer Mehdiyev, in this area the interests of some departments collide: “Therefore, in the management of this area, health care policy, payment for medical insurance, quality control of treatment should be in different structures.”
The economist noted that the compulsory health insurance system can prevent corruption. But for this a system of public control must be created. There may be participation of the media, civil society institutions, but in this case, the interest in organizing such control does not seem convincing.
Azer Mehdiyev believes that in order to assess the performance of this system, first of all, a correct assessment system should be created: “At the same time, I do not expect such high results from the hospitals of the Soviet period. The main issue is that this system wins the trust of citizens, and this is a difficult issue in Azerbaijan. ”
One of the founders of the public association of Azerbaijani doctors, radiologist Aydin Aliyev told Turan that if the introduction of the compulsory health insurance system in the country is positive, then 1-2 months should pass in order to determine how successful the system for doctors is: “True, the official salary of doctors has increased and is about 300 manats. But we all know that neither doctors live on such a salary, nor representatives of another profession. The work of one worker on someone’s personal plot is 20 manats a day, which is 600 manats a month.
The doctor noted that if there really is a desire to end corruption, bribery and other problems, then the relevant departments should calculate the unofficial monthly income of doctors and calculate the average figure, and then adjust the salaries of doctors working under the compulsory medical insurance system according to it.
“If a doctor has earned 2-3 thousand manats until now, then he formed his budget accordingly, and when tomorrow his income decreases, he will look for ways to compensate for previous income, go to private hospitals or other countries,” he said.
According to the expert, if the doctor’s income is unsatisfactory, then the quality of the medical services provided by him automatically decreases: “Then patients will turn to private hospitals, and a return to the previous system will take place.”
Source: Turan News Agency