I was in Tbilisi last week for the launch of Georgia’s new five-year health strategy, "Affordable and Quality Health Care," the first strategy since 1999. It’s a milestone in the country’s ambitious health reform program, summarizing what has been achieved, the challenges ahead, and options to address them. And more importantly, the strategy reflects the government’s commitment to continue redesigning the health system and improving the health status of the population through the adoption of multisectoral actions.
The Georgians should be proud. Since 2006, the government has radically transformed the health system, moving rapidly from a budget-funded direct provision of medical care in public facilities to subsidizing health insurance premiums for the poor. Private health insurance cum services providers, who are increasingly operating as integrated health management organizations, are delivering services in the benefit plan. The initial results are promising: Health insurance coverage has risen steadily from about 2 percent to 40 percent of the population, and out-of-pocket health care expenditures among the poor have been decreasing, particularly after a basic drug benefit was added to the health insurance plan.
You may say that the Georgian experience is nothing new because many countries across the globe have adopted or are adopting similar arrangements—and some countries have more to show. However, this experience shows us how unwavering leadership is a key to persevering on the sometimes rocky path of health system reform.