By Nane Atshemian
The Armenian government reported on Monday a sharp increase in the number of people visiting state-run policlinics since the abolition, effective from January 1, of all medical charges levied for disease prevention and non-surgical treatment.
Officials said in Yerevan alone policlinic visits this month were 47 percent up from January 2005, while the number of medical tests performed there jumped by 51 percent compared to the same period last year.
The official statistics reflect the first practical effects of the government’s decision last October to expand the hitherto limited scope of medical services provided to the population free of charge. The move was part of the government’s stated efforts to make healthcare more accessible and affordable to Armenians.
Public access to healthcare declined dramatically following the collapse of the Soviet Union as Armenia’s cash-strapped governments allowed state-owned medical institutions to legally charge their patients. The problem was compounded by the practice of informal payments existing in virtually every hospital and policlinic.
A nationwide household survey conducted by the National Statistics Service in 2003 found that only one in three Armenians visits a medical facility when having health problems. The government says that the new system of free primary healthcare will improve public health by helping many citizens prevent grave illnesses.
According to Armen Soghoyan, head of the health department at the Yerevan municipality, policlinic visitors in the capital are now charged only for undergoing medical examinations that are needed for obtaining a driving license or other documents. “If a particular citizen is asked for money they can complain to the head of a policlinic, the Yerevan municipality’s health department or the Ministry of Health,” he told reporters.
Anecdotal evidence and witness accounts suggest that the government decision is being implemented. “I had a sore foot and went came here on January 4,” said an elderly patient at a policlinic in central Yerevan. “I also suffer from diabetes and come here to see my doctor. It’s all done for free. I have not been charged a penny.”
“They didn’t ask for money,” confirmed a middle-aged woman who just visited a gynecologist. “I am very happy with that.”
Doctors at the policlinic made similar assurances. “We make it clear to everyone that medical services are free of charge and have parents [of child patients] sign appropriate documents,” said Susanna Chobanian, its chief pediatrician. “Things are strict here.”
But privately, policlinic doctors also complain that they are not being rewarded or somehow compensated for their increased workloads and the loss of bonuses which they used to draw from proceeds from medical fees. Their average salary was due to rise to 50,000 drams ($110) starting from January. However, many of them work on a part-time basis, meaning that they earn a meager 25,000 drams a month. Medical personnel at Armenia’s mainly private hospitals, where very few services are free, get paid much better.
Chobanian complained that she and her colleagues still do not know what their new salaries are. She said they are also worried that the government will resort to mass layoffs to ensure the promised pay rise.
In this situation, not all policlinic patients are keen to make use of their new privilege. “I am ashamed of visiting a doctoring and not giving something,” admitted one woman. “Life is so tough for them.”