One of the negative actions being done in Armenia is taking money at the medical institutions. International corruption specialists emphasize the importance of raising the level of social conscientiousness more than correct state strategies and political power.
According to head of the Mother and Child department of the Ministry of Health Karine Saribekyan, any patient who is demanded to pay must be informed about his or her rights, pay the amount at the cashier and demand a receipt. In accordance with one of the development projects of the UN, 59% of children up to 7 years and younger get free medical treatment in Armenia, 47% get emergency help and 23% get treated for free in the hospital; 37% of patients have the right to get free medicine and 8% from the obstetrician/gynecologist section. Studies show that the rest of the people have not gotten treatment because they don’t know anything about their rights or they are simply obligated to pay. The free medical treatment or compensation program of the Health Ministry started in 1997 when the Soviet health plan turned into a financial management mechanism. Children until the age of 7, despite diagnoses and social levels, are included in the state funded medical treatment program according to their age group. The money provided to the children of Yerevan this year is estimated to be 1,113,295,000 drams from the state budget. An average of 80-90,000 drams is paid for one treatment, which is calculated based on the days spent at the hospital. However, the specialists claim that state funding does not take care of all the expenses of the hospital. Head of the “Arabkir” hospital Ara Babloyan says that they have funded medical treatments up to 400 million drams, but at the same time the hospital has spent 600 million drams. “We have had 5000 patients getting treatment in the hospital and 12,000 getting treatment outside the hospital,” says the head of the health institute for children and adolescents. “We have a child who is in bed and we pay 30-40 dollars daily, however, the state provides approximately 80,000 drams (approximately $200) for one case. We have an official payment and if the parent is able to pay, then the patient getting medical treatment funded by the state can make a 15,000 dram payment also. But the quality of service does not depend on whether the patient has the money or not. Our goal and philosophy is so the quality of the child’s medical treatment does not depend on how much the parent can pay,” says Mr. Babloyan.
The payment is the difference in real expenses and state financing. However, for children up to the age of 7, this principle does not work although it is the law. Basically, by getting money from the patients illegally, the hospitals are solving the inner economic problems and “stuffing their financial gap”. Mr. Babloyan said that he was ready to find and fire the doctors at the hospital that take bribes. “I cover up the deficit with my contacts and I do my best by mobilizing people who want to help our country. For example, the “Gharagyozyan Fund” is our sponsor because it is informed that there is a huge gap between need and possibilities. The sponsors help children suffering from chronic diseases, children who feel the need to be treated throughout their whole lives. We treat them for free,” says Mr. Babloyan.
The “168 hours” newspaper edition had received a protest letter from parent S. Ayvazyan, who was at the “Surb Astvatsamayr” hospital with her child in May of this year. She complains about the situation at the “Newborn pathology” department where the doctors don’t take their jobs seriously, and the trade going on in the hospital. We present a part of the letter: “If you have money, they will help your child. If not, then may God help you. We were the ones buying the medicine, even the milk bottle. The nurses were demanding money for their job. If you couldn’t pay, you were hated. Even the head of the department was asking for money. I was simply amazed. I didn’t know whether to pay the department staff or buy my child medicine.”
Another parent A. Harutyunyan was in the Somatic department of the same hospital in July of this year and witnessed how a needy family excused itself from the hospital and escaped due to the fact that it had not been able to pay the amount asked by the head of the department. They left without any documentation. In order to register out of the hospital, generally the patient fills out an application where the parent states that he or she is informed that the medical treatment has been funded by the state and has signed for it. Of course, as stated by parent A. Harutyunyan, parallel to the state financing document, the parent gets “informed” about the amount of money that must be paid also. According to Harutyunyan, the amount ranges from 25-50,000 drams.
Owner of the “Surb Astvatsamayr” hospital, chief children’s surgeon Nikolay Dallakyan did not consider the letter that important and said that he is pretty tolerant when it comes to these types of letters and complaints. In his words, what they do for the children should be praised and appreciated. Their slogan is “The child has nothing to do with the parents being rich or the poorest.” He invited 10 year old David in order to prove what he had said. It turned out that the boy with the pale face with no expression had been transferred to the clinic when he was on the verge of dying (according to the medical analysis, the boy’s esophagus had exploded after a really heavy cough) and went through several difficult operations for restoring the esophagus and trachea. According to N. Dallakyan, the money spent on him is already estimated to be 20,000 U.S. dollars in drams. David’s grandma, who had accompanied the child, said that they had not spent one penny during this whole time. “Doctor, if they go against you, then they will go against God,” said the grandmother. The contradicting cases do not justify the money taken by force and illegally when the medical treatment is financed by the state. This is a result of the carelessness of the corresponding supervising bodies.
“If the child has been given a pass by the polyclinic and receives stationary medical treatment at the hospital, then anything having to do with treatment is free,” says head of the Mother and Child department of the Ministry of Health Karine Saribekyan. Of course, there are exceptions. For example, computerized tomography with high tech equipment and the X-rays are paid for by everyone. K. Saribekyan also informed us that, children are treated in the dispensaries in order to prevent them from becoming handicapped and this is all funded by the state.
Children usually get ill during the winter. Owner of the “Surb Astvatsamayr” hospital N. Dallakyan says that they register 15-16 extremely ill patients in the hospital’s reanimation department where there are 12 beds. That is why the expenses for the children’s reanimation room exceed the money provided by a couple of times. The owners of the “Arabkir” and “Surb Astvatsamayr” hospitals are of the opinion that in order for the people to come to terms with the doctors, some financial and systematic problems must be solved-meaning, there must be health insurance.