Universal health insurance finally on it’s way, in Azerbaijan

Azerbaijan is preparing for the introduction of compulsory health insurance to replace government payments for healthcare from general taxation.

After many years of promises, Azerbaijan will bring in mandatory health insurance in the near future, says Hadi Rajabli, chairman of the Committee on Social Policy of the Parliament.

Azerbaijan is preparing for the introduction of compulsory health insurance for the 9.7 million people in the country, to replace the old Soviet style government payments for healthcare from general taxation.

Azerbaijanis will still receive free basic healthcare at the point of access, but additional items and treatment will be charged to their insurance scheme, which will be compulsory for all.

It is looking at how other governments operate the principle before agreeing a solution and date.

Hadi Rajabli explains, “We have a legal basis for compulsory health insurance. Radical change of the health care financing is needed and the issue is rather late. Experts are studying the international experience. The experience of Croatia and Turkey in this area is very attractive. Azerbaijan adopted a law on medical insurance in 1999. According to the law, a compulsory form of health insurance is an integral part of the state social insurance policy and ensures the provision of medicines and medical service to the population.”

In Croatia health insurance contributions are compulsory for all citizens in employment and for employers. Dependent family members are covered through the contributions made by working family members. Self-employed citizens must pay their own contributions in full. Vulnerable groups such as old age pensioners and low-income earners are exempt from payment. Some citizens supplement their state healthcare service with additional private health insurance.

In Turkey the universal healthcare insurance system is funded from general taxation, plus employer and employee contributions. One in three Turks also have private health insurance.

One problem in Azerbaijan is that only local companies that are an open joint stock company can offer insurance. Health insurance is allowed but very few people have this and insurers are losing money. Foreign insurers cannot directly offer insurance in the country but they can open representative offices- or set up joint ventures or open wholly owned local subsidiaries. They cannot open branch offices there.

The proposed plan in Azerbaijan is for all citizens to have a universal health insurance card and all doctors, clinics and hospitals will offer free treatment and prescription drugs at the point of care and then charge the cost to the insurance fund. Whether there will be co-payments for some services is not decided. Whether opt out health insurance will be allowed, or just voluntary top up and/or alternative cove is also not yet decided. It will almost certainly be done using a single state owned health insurance fund rather than using authorised private insurers.