Social health insurance system in Georgia: development barriers (ჯანმრთელობის სოციალური დაზღვევა საქართველოში: განვითარების ბარიერები)

Georgia’s healthcare system reform, which began in 1995, was one of the first state reforms in the country’s recent history. When creating a new financing system, the choice stopped on the social insurance model. The aim of the paper is to study the reasons for the introduction of health social insurance in Georgia, in particular, why Georgia chose the model of health social insurance (Bismarck model) and not general tax financing (Beveridge) and what were the challenges associated with its development? The social security system, unlike Beveridge’s general tax financing system, is more focused on introducing market mechanisms where health responsibilities are evenly and equitably distributed among the state, the employer and the employee. Despite the achievements, the introduction of health social insurance turned out to be more difficult than expected. Due to the ongoing economic crises, the state was unable to finance its promised commitments, resulting in a chronic shortage of funding for the health care. The United National Movement, which came to power in 2004, abandoned the construction of a social security system and switched to a general tax financing model (Beveridge), which excludes the insurance principle and is quite similar to the Semashko system, as the state plays a more dominant role. From general tax revenues. The same thing happened in 2012, with the new political party “Georgian Dream - Democratic Georgia” coming to power. Given that the social insurance system is the best way to mobilize additional funds for the health sector and therefore sustainable funding, as well as better ensure cost containment and increase the transparency of the system, it is advisable to promote the development of social insurance in the country. The healthcare sector needs reform consistency, continuity and heredity. Despite the change of governments, in the long run the strategic course should not change drastically and the achievement should not be denied due to the change of political conjuncture.
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Social Security system, healthcare reforms, general tax financing (Beveridge) model
Economics and Business, №2, 2021, pp. 196-213