Category: 2023

Vietnam –

A Vietnamese woman has returned VND4.5 million ($190) to an Armenian tourist who lost it on Tuesday while visiting Hanoi’s Old Quarter.

Armenia's government is planning a state-funded universal health insurance system that promises uniform quality care for all by 2027.

Critics say the plan is doomed as it does not address systemic inefficiencies and places additional financial burden on already struggling taxpayers.

The government approved the concept at a cabinet meeting in February covering all medical services besides dentistry and cosmetic medicine and intends to present a relevant bill in April.

It is to be implemented in stages starting in 2024, when the first group, public sector employees, would join the system. From 2025, pensioners would be enrolled at the state's expense. In subsequent years, coverage would gradually spread to other groups. And in 2027 the system is to become mandatory for all citizens, by which time the government promises to comprehensively renovate or re-equip at least 50 medical centers.

Paying for it

The government promises an equitable system that citizens will pay into according to their means and that everyone, "regardless of social status," will receive equal quality care.

In parallel, a standardized, nationwide electronic system will improve the quality of medical services across the board, according to Health Minister Anahit Avanesyan.

But many details remain to be worked out.

Samvel Kharazyan, an expert on health financing at the Ministry of Health, told Eurasianet that the new system will be funded in part by a fixed amount, based on income, automatically withdrawn (like income tax) from salaried workers' wages. Kharazyan estimated that the cost of the plan would be "slightly more" than 200,000 drams (about $500) per capita per year.

No matter how equitably distributed those charges, they will likely put substantial financial strain on many Armenians. According to official statistics, 26.5 percent of the population live in poverty.

While unemployment stands at 11.6 percent, only about half of the able-bodied adult population have officially registered employment (the differential being the substantial number engaged in agriculture).

The amount of the healthcare fees to be charged to members of different income brackets will be determined, at least in preliminary form, in the draft bill due to come out in April. But ultimately those numbers will be informed by a universal declaration of income system to be introduced by 2025, Kharazyan said.

"Only after that will we be able to understand who has what kind of income in the country and in what amount the state should subsidize the insurance premiums of certain groups of citizens," he said.

The proposed system has reminded some of a plan put forward by Prime Minister Nikol Pashinyan's government in 2019 that envisaged a 6percentage point increase in the flat income tax rate, known at the time as a "health tax." The proposal was unpopular and was shot down by the Finance Ministry.

"Achilles' heel" of Armenian medicine

It is the confluence of high cost and low quality of care that experts call the "Achilles' heel" of the Armenian healthcare system.

According to the World Health Organization, non-communicable diseases account for 93 percent of all deaths, compared to 71 percent worldwide. And the latest WHO data from 2016 shows that people in Armenia have a 22 percent chance of dying prematurely – that is, before the age of 70 – from four non-communicable diseases: cardiovascular disease, diabetes, chronic respiratory disease and cancer.

But at the same time healthcare spending accounts for around 12 percent of GDP, which is higher than in Israel (8 percent), Italy (10 percent), Finland (10 percent) and comparable to France (12 percent) or Germany (13 percent).

Haykaz Fanyan, the head of the Armenian Center for Socio-Economic Research, in remarks to Eurasianet, pointed to World Bank data from 2019 that found Armenians cover about 85 percent of healthcare costs out of pocket, which is almost twice as high as in neighboring Georgia.

Avanesyan, the health minister, acknowledged that "catastrophic healthcare costs" are keeping Armenians in poverty, noting that about 9 percent of the population devotes more than 25 percent of consumer spending to healthcare, one of the highest rates in the region.

And Kharazyan, the Health Ministry official, said much of this problem stems from people's aversion to seeking preventive care.

"As a rule, people, due to scarce financial resources, put off dealing with health problems until they can no longer be postponed and urgent medical intervention is needed. In this case, you must use much more expensive services and it is often not possible to ensure a favorable outcome of treatment," he said.

And it is for this reason that the proposed reform will focus on preventive care, requiring those insured to seek regular medical screenings, Kharazyan added.

Private insurers' future uncertain

The government is proposing not only to overhaul the health insurance system but also to improve the admittedly poor quality of care in parallel.

Experts and businesspeople are skeptical that this can be accomplished, and also worry about the effect on existing private insurers.

The American Chamber of Commerce, one of Armenia's leading business associations, has expressed concerns about corruption risks arising as both the collection and spending of insurance premiums are placed in the hands of a fund to be specially created. It also calls for state cooperation with private insurance companies to prevent the "monopolization" of the industry in the hands of the state.

But the government counters that involving private insurers in the program would drive up costs.

Kharazyan, the Health Ministry official, said that "as a rule, 20-25 percent of the cost of these [private insurance] packages cover administrative costs of the companies. But the state fund will be able to keep these costs at a level of 2 percent."

So, if the proposed reform is implemented, what impact will it have on private insurers?

Arevshat Meliksetyan, chief executive of Ingo Armenia, one of the country's largest insurance companies, told Eurasianet that his industry would initially be dealt a blow, but that ultimately the state will be forced to share the market with them.

"No government, no fund can cope with such a volume of clients. I am sure that in a few years the government itself will offer part of the insurance packages to private companies,” he said.

AFP - Armenian officials on Thursday accused Azerbaijani troops of opening fire and killing an Armenian soldier along the volatile border between the two Caucasus neighbours locked in a decades-long territorial dispute.

A nine-game unbeaten run between 2020 and 2021 included a five-game winning streak which saw Armenia win their first three 2022 World Cup qualifiers.

Georgia, Iceland and Romania were among the sides they beat and they sat top of the group involving Germany with 10 points from four games in qualification for Qatar.

All has unravelled since though, with the international retirement of Henrikh Mkhitaryan not helping matters, as Armenia took just two points from their remaining six qualifiers, finishing way off the top two.

Two wins in their last 19 fixtures also saw them relegated from League B of the UEFA Nations League last year, conceding 17 goals in their final five games.

Losing 5-0 at home to both Ukraine and North Macedonia in the last 12 months has dented confidence even further too, leaving Armenians with little hope of making progress from this group.

They have also conceded nine goals on two occasions in the past three-and-a-half years, to Italy and Norway.

This fixture will be the first played by the Turkish national side since the devastating earthquake which struck the country last month, so manager Stefan Kuntz will hope his squad can help bring the nation together at such a traumatic time.

On the pitch, it looks set to be a tricky group for Turkey to navigate, as Croatia are major competition regulars and Wales have reached three of the last four major tournaments.

With those two nations facing off in Split on the same night, Turkey must make a fast start with one or potentially both of the sides guaranteed to drop points on opening night.

Turkey cruised to promotion in the Nations League after remarkably finding themselves down in League C, but they completely took their eye off the ball, drawing at home to Luxembourg and losing in the Faroe Islands after promotion was secured.

They are the only two blips in Turkey's last eight matches since they lost to Portugal in a World Cup playoff, winning their other six matches since.

Form was rocky after being the worst-performing side at Euro 2020, but the Crescent Stars were still unlucky not to qualify for Qatar having lost only once in their section.

In a devilishly close group, they were edged out of top spot by the Netherlands, but just about made the playoffs ahead of Norway and Montenegro.

These two nations were drawn together in qualifying for the 2010 World Cup, with Turkey winning both games home and away 2-0.

Armenia's star quality comes in the form of two Argentine-born attacking outlets in Lucas Zelarayan and Norberto Briasco.

Briasco has only been used sparingly since his debut five years ago and will still have to battle with Sargis Adamyan for a starting spot up front.

Grant-Leon Ranos has been rewarded with a first call-up after scoring 16 goals for Bayern Munich II so far this season.

FC Astana duo Kamo Hovhannisyan and Varazdat Haroyan are their two most experienced players and should both start on the right-hand side of Armenia's defence.

Despite never having a great record for Turkey, it will be hard for Kuntz to look past Getafe's Enes Unal as his starting striker here.

The 25-year-old has netted six goals in his last four La Liga outings before the international break, and with there still being no call up for Brighton & Hove Albion's Deniz Undav, who is yet to decide between representing Turkey or Germany, Unal should start.

There is plenty of class in the middle of the pitch for the visitors, with Hakan Calhanoglu, Orkun Kokcu and Kerem Akturkoglu all in excellent form across Europe.

The main worry is at centre-back, as Caglar Soyuncu and Merih Demiral have both barely featured this season, while Ozan Kabak has struggled at lowly Hoffenheim.

Armenia possible starting lineup:
Buchnev; Hovhannisyan, Haroyan, Voskanyan, Calisir; Barseghyan, Spertsyan, Bayramyan, Shaghoyan; Zelarayan, Adamyan

Turkey possible starting lineup:
Cakir; Zeki Celik, Soyuncu, Demiral, Elmali; Calhanoglu, Ozcan, Kokcu; Under, Unal, Akturktoglu

Zelarayan will almost certainly play a key role if Armenia are to do anything, and he may get some joy against a fragile Turkey rearguard.

However, the class in the ranks for the visitors is clear, and they should take three points back to Bursa, where they will face Croatia on Tuesday.

For data analysis of the most likely results, scorelines and more for this match please click here.

https://www.sportsmole.co.uk/football/armenia/preview/preview-armenia-vs-turkey-prediction-team-news-lineups_509725.html 

BAKU. March 22 (Interfax) – A phone conversation with Azerbaijani President Ilham Aliyev took place at the initiative of U.S. Secretary of State Antony Blinken, the Azerbaijani leader's press service said.

During the conversation, Aliyev said Azerbaijan is fully committed to the peaceful agenda and is ready to normalize relations with Armenia and sign a peace treaty in the near future. He said he had presented to the Armenian side the text of a peace treaty with recent proposals and amendments.

The phone conversation addressed the situation on the Lachin-Khankendi road.

Russian peacekeepers and the International Committee of the Red Cross have ensured the passage of over 4,700 cars, people in need of medical assistance and people accompanying them since December 12, 2022, Aliyev said.

"Therefore, the information on the presumed blockade of this road is false propaganda of Armenia," he said.

Aliyev said he is seriously concerned by Armenia's use of an additional road for, as he said, illegal transportation, personnel rotation on Azerbaijani territories, where Russian peacekeepers are temporarily deployed, and also the fact that, in his words, some 10,000 Armenian troops are still on the territory of Azerbaijan.

In this regard, Aliyev especially emphasized the need to create a border checkpoint on the last point of the Lachin road of Azerbaijan on the Armenian border.

Aliyev also said the Armenian side in the past few weeks pursued policies aimed at deliberate escalation of the situation, abusing the deployment of the EU mission in Armenia. There have been situations of intensive ceasefire breaches by Armenian troops, he said.

According to the press service, Aliyev said two Azerbaijani troops had been killed as a result of provocations by illegal Armenian military formations on March 5 and an Azerbaijani border guard had been wounded in a provocation on the Azerbaijani-Armenian state border on the territory of the Zangilan district on March 20.

Blinken, for his part, emphasized again that the United States will continue working on normalizing the relations between Azerbaijan and Armenia and signing a peace treaty, the Azerbaijani leader's press service said.

Aliyev also said Azerbaijan is ready for contacts with Armenian residents of Karabakh, which is why they have been invited to Baku by the Azerbaijani presidential administration to continue contacts on reintegration and to discuss infrastructure projects.

 

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."