How Much Is "Free" Medicine?

To provide medicines to the population, the state budget of Azerbaijan presumed 100-110 million dollars last years. This means that the per capita account in Azerbaijan is slightly more than $ 10 per year, the economist Rovshan Agayev told Turan.

"Looking through the reports on the countries-members of the Organization for Economic Cooperation and Development, one can see that in these countries from USD 300 (Poland, Norway, Czech Republic) to USD 1,000 (USA) is spent annually per capita. In addition, 15 - 40% of the costs of drugs are in retail trade, and the remaining funds are allocated directly to hospitals and other inpatient facilities where patients undergo treatment.

Most of the retail costs (up to 80%) fall on public health insurance funds, while the rest is the costs of citizens, or private health insurance funds, such as in the Netherlands. For example, in Estonia (a country of the post-Soviet space), the share of the state is 54%. For us, this is still an unattainable statistics. We know one thing - the expenses of citizens are many times higher than the funds allocated from the budget, although local medicine is considered free. In fact, the state actually enters into our pockets," the expert explained.

70% of Health Care Costs Paid by Citizens Themselves

In the meantime, health care this year received 45 million dollars less. This year, 800 million manats was allocated from the state budget for health care - 180.3 million manats will be used to finance targeted programs and activities; 22.2 million manat - for treatment of kidney failure; 18.5 million manat - for the treatment of such hereditary blood diseases as hemophilia and thalassemia; 39.3 million manats - for financing of national measures against cancer; 36.1 million manats - for financing of national activities to combat diabetes, etc., according to the Doing-Business-2017 report.

In particular, it is noted that the funds allocated for the healthcare sector will amount to 4.7% of the budget expenditures. "The lack of a health care system that guarantees the quality of health preservation is a sore point of the country. In Azerbaijan, at the expense of the state budget, about $ 45 per capita is invested annually in this sphere. At the same time, the expenses of citizens for medicine are 3-4 times higher than those claimed," Agayev said. The expert cites the framework agreement on partnership (CPF), approved by the Board of Executive Directors of the World Bank for Azerbaijan in 2015 for 2016-2020. The document contains interesting details.

"These figures are not published in official data and statistics. For example, according to the World Bank, spending on the health of the average family is 10% of total consumer spending. At the same time, citizens pay 70% of health care costs on their own and only 30% are covered by the funds allocated for this purpose from the state budget. Recall that this year AZN 800 million was allocated for health care from the state budget. Taking into account the rate of AZN and the World Bank calculations, it can be concluded that the real amount of healthcare expenditures is AZN 2 billion," the economist estimated.

Out of 62% of the non-refundable expenses of patients in Azerbaijan, more than 70% is spent on pharmaceutical preparations, 60% of which are imported. Turkey, Iran, India, Ukraine and Russia supply relatively inexpensive drugs, while medicines from the US, France, Germany and other EU regions are much more expensive. According to experts, the monopolization of the import of medicines and the lack of transparency in public procurement remain a big problem.

Due to the lack of local production, Azerbaijan is also a large market for investment in medical equipment. Ultrasound scanners, electrocardiographs, X-ray equipment, laboratory analyzers, electronic surgical instruments, endoscopes, gynecological instruments and devices, catheters, drains and other consumables are in great demand. At present they are imported from the USA, Germany, Japan, France, Russia, Turkey and other countries.

Over the past decade, more than 60 medical institutions were built, and more than 500 research institutes and hospitals were reconstructed and modernized. According to official statistics, today there are 28,489 doctors and 56,842 nurses working in the country, 750 hospitals and 1,670 polyclinics. The number of beds is 70,000. Meanwhile, the health infrastructure is concentrated mainly in the capital. For the residents of the rest of the country, there is not enough of a bed capacity. Today, most of the citizens who can afford better treatment travel to neighboring countries, such as Iran and Turkey, which, as they are convinced, have a better quality of medical services. For example, in 2012, 4,106 Azerbaijani citizens were treated in Turkey, and in the same year, about 1,600 Azerbaijanis crossed the border with Iran daily for medical procedures.

The biggest problem of the industry is the lack of human capital - there are not enough doctors and nurses who have the most up-to-date knowledge and experience. Thus, even for money, good health care is not guaranteed in Azerbaijan. No less relevant is the problem of corruption. Commenting on the situation, a member of the Republican Alternative Movement (REAL), Doctor Khadija Hajili noted that the main cause of the deplorable state of public health in Azerbaijan is total corruption. -0-