Country has long had low spending on healthcare, leading to huge pressure on ordinary citizens.

Ani Aikuni is all too familiar with the stress of grueling and expensive cancer treatment.  

“It is really difficult, when you have to deal with a serious diagnosis and at the same time have to think about getting money to cover the costs of treatment,” the 37-year-old entrepreneur told IWPR. “If a person does not have financial resources, this can lead to a lot of stress. All this, of course, affects the patient’s physical and mental state.”

Aikuni, who was diagnosed in 2015, said that his family had quickly spent all their savings on treatment.

His life was only saved, he continued, thanks to a fundraising campaign launched by friends which brought in 30,000 US dollars of donations from all over the world. After recovering, Aikuni started a charitable fund providing financial support for cancer patients.

He wholeheartedly welcomed Armenia’s introduction of a new health insurance system he said could save many lives.

“It would be great if the new health insurance could alleviate the financial burden for patients,” Aikuni continued. “If everything is well organised, citizens will only benefit. It is critical to ensure that a person can have access to health care services immediately after being diagnosed, so that they don’t wait months for their turn.”

Experts have long debated the need to reform Armenia's current healthcare system, under which the general public pays for treatment, while those from vulnerable and disadvantaged groups can access free care.   

Armenia has low public funding for healthcare – 5.4 per cent of state budget expenditures or about 1.4 per cent of GDP, at least four times less than countries from the same income group.

According to ministry of health data, about nine per cent of the population spent more than a quarter of their entire consumer spending on medical care.

On February 2, 2023, the government decided to introduce a new system over the next four years. Announcing the measures, minister of health, Anahit Avanesyan said that the goal was “to provide timely and proper medical services to every citizen, regardless of their solvency, gender, age, etc”.

The strategy will be implemented in stages. After a year of preparatory work, 2024 will see it rolled out to cover some state employees, children and those from marginalised groups including socially disadvantaged citizens and those with special needs.  

In 2025, the system will extend to those aged 63 and over, as well as public sector employees. In 2026, all those in employment will have the opportunity to join. People also have the option to join voluntarily ahead of schedule.

“I often meet patients who cannot afford the costs of cancer treatment."

Yerevan aims to reduce mortality rates, increase life expectancy and ensure fewer people live with health-related disabilities.  

“The plan is to cover 95 per cent or more citizens of the Republic of Armenia in the final stage of the comprehensive health insurance programme; all citizens can benefit from the same services, regardless of their income and social status,” Avanesyan said.

However, she did not specify the annual cost for insurance, saying only that it would be a fixed amount for all regardless of income.   For those who earn less than the average salary, part of the insurance cost would be subsidised, while those currently using state-funded free health care services would have their costs covered.

In various public discussions, officials previously stated that the annual cost for health insurance might range between 150,000-200,000 drams (375-500 dollars).

The programme will cover diseases with a high mortality rate in Armenia, particularly, cardiovascular conditions, cancer and and diabetes.

For example, for oncology patients, the programme will cover costs for surgery, chemotherapy and up to 22 sessions of radiation therapy. Patients will also receive financial aid of 1.6 million drams (4,000 dollars).

Oncologist Vahe Ter-Minasyan welcomed the decision, noting that “I often meet patients who cannot afford the costs of cancer treatment and often get poorer in the course of the long-term treatment, losing not only health, but finances and property”.

The scheme would not entirely cover the amount needed for cancer treatment, but would certainly help many, he continued.

“Unfortunately, 1.6 million drams are not enough, because there are cases when this amount is only enough to buy medicines for two months. But on the other hand, of course, it’s better than nothing."

Along with the insurance programme, the minister of health also promised to upgrade infrastructure, building or modernising 50 medical facilities by 2026.

Deputy prime minister Tigran Khachatryan said that he hoped that state funding to the healthcare sector would also be stepped up

“We must increase the amount of resources allocated to the healthcare system by several times, thereby emphasising the significance of public health,” he said.

Although the comprehensive health insurance has not yet been formally adopted, 89 per cent of users voted in favour of it on the public discussion platform e-draft.am.

But the new system has not met with universal approval.

Economist Tigran Jrbashyan argued that it would only change the way healthcare was funded, rather than improving the efficiency and quality of the system itself.

He said that comprehensive health insurance should only introduced after healthcare reforms were carried that could increase the chances of its successful implementation. The sector simply did not function properly, he continued.

“For 30 years, the reforms in the healthcare sector have been carried out without focusing on the efficiency and effectiveness of the sector,” Jrbashyan said. “As a result of this, we are in a situation, when Armenia, in terms of number of hospitals, doctors and beds, outdoes most developed European countries, but as for the efficiency, is falls behind many less developed."