Medical workers protest in front of RA NA, submit collective letter  to legislature

ArmInfo.. Medical workers protested in front of the Armenian parliament and submitted a  collective letter to the legislature, demanding parliamentary hearings to discuss the shortcomings and risks of universal health insurance and make the necessary adjustments.

They called for the rights of medical workers to be taken into account and for the  numerous problems that have arisen during the implementation of this  system to be addressed. Doctor Gevorg Grigoryan, speaking with  journalists, emphasized that parliamentary hearings are the only way  to air their complaints. He noted that a repressive mechanism  currently exists-threats of dismissal and pressure on doctors-that  prevents them from raising their concerns.

Anush Poghosyan, chair of the Right to Health public organization,  spoke about the difficulties medical workers have faced since the  introduction of the health insurance system. She noted that she has  received numerous complaints about salaries not only being paid late,  but also significantly lower than before.  "Hospital staff are  receiving 30% less salary, and those in outpatient clinics are  receiving two and even three times less. Furthermore, salaries were  paid late, only on February 20th. In response, Health Minister Anahit  Avanesyan asked for understanding, as this is a new system,"  Poghosyan said.

She cited the lack of proper awareness of both healthcare workers and  citizens about their rights as the biggest shortcoming of the health  insurance system. Furthermore, Poghosyan recalled, the system was  launched on January 1st without preliminary agreements with hospitals  and without the timely establishment of the Health Insurance Fund,  which led to serious problems.

"Today, healthcare workers are facing a heavy workload, as doctors  are forced to navigate confusing documentation. And outages on the  ArmMed website (Armenia's unified e-health information system - ed.)  can last for hours, making it difficult to prescribe medications,"  Poghosyan noted.

As a result of this situation, she said, hospitals have also been  burdened, as patients with uncomplicated cases frequently seek care,  leading to queues. "Therefore, the entire medical system is under  great strain," Poghosyan noted.

"It's also necessary to review tariffs. Because when cases are paid  below cost, this leads to 'illegal turnover' and a reluctance on the  part of doctors to serve patients with health insurance," the  chairwoman of the public organization added.

As a reminder, mandatory health insurance entails a phased  implementation over three years. The first phase began on January 1,  2026, and covers children under 18, individuals 65 and older (even if  employed), individuals with disabilities aged 18 to 65, members of  socially vulnerable families, and individuals earning over 200,000  drams. The base cost of an insurance policy in 2026 will be 129,600  drams (10,800 drams per month). Part of this amount is reimbursed  from payments to the Zinapa Military Insurance Fund. These payments,  increased in 2021, are now returning to their previous level of 1,000  drams, regardless of salary.  The remaining portion will be  reimbursed to beneficiaries upon filing their annual personal income  tax return. However, in 2026, these amounts will be reimbursed  monthly from the state budget. Insurance payments will be made by a  tax agent, meaning they will be withheld from wages in the same way  as income tax, social security payments, and other benefits. This  year, individual entrepreneurs will also benefit from the system and  will be responsible for paying their own insurance premiums. Overall,  by 2026, health insurance will cover approximately 1.6 million  people. A state fund has been created to manage the system. It will  operate under temporary management for three months, after which a  state selection committee will form its board of directors, which, as  stated in the Concept for the Implementation of Compulsory Health  Insurance, will be chaired by the Minister of Health. It is worth  noting that, according to the ACSES analytical review, the current  model of Universal Health Insurance is a serious deviation from the  principles of a market economy, creating risks for the long-term  investment attractiveness of the sector.

In connection with the above, she noted that their demands are as  follows: to hear from the professional community, hold joint  discussions in the legislative body, and conduct accurate  calculations so that hospitals are motivated to provide high-quality  patient care and medical workers receive a decent salary.

Specifically, financial calculations indicate that the system  implemented in 2026 will, at best, account for approximately 23% of  healthcare expenditures, which is lower than the indicators in the  countries examined in the document (the lowest indicator is in Greece  at 32%). Furthermore, international experience shows that, given the  proposed model, healthcare infrastructure, and low funding levels,  patient satisfaction in Armenia will likely be lower than the average  for the countries examined, potentially overshadowing the reform.  Furthermore, the establishment of actual prices and maximum  compensation/compensation prices in certain cases may also lead to an  increase in shadow turnover, particularly when the actual price is  double the established compensation amount, and the citizen is forced  to pay the difference in cash.