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Healthcare in Georgia (country)
==Historical Introduction==
Georgia became part of the Russian Empire in 1801, remaining as such until a brief period of independence from 1917 to 1921. In 1921, however, it was incorporated into the Union of Soviet Socialist Republics (USSR), where it remained for the following 70 years 〔Gamkrelidze et al. 2002. "Health Care Systems in Transition: Georgia." ''European Observatory on Health Care Systems''. Vol. 4, No. 2.〕 From 1921 to 1991, the Georgian health system was part of the Soviet system.
The “Basic Law on Health in the USSR and Soviet Republics,” also known as the Semashko model, provided the framework for each Soviet republic and was characterized by almost complete public ownership of healthcare services. Planning, organization, control and allocation of nearly all resources were undertaken in Moscow, while few responsibilities were delegated to the Georgian health authorities.〔 Healthcare was meant to be free at the point of delivery, but illegal out-of-pocket payments to health professionals were also common.〔Gotsadze, T. and E. Schouten. 1997. Healthcare Reforms in Georgia: An analytical overview. UNICEF & Health Net International: Tbilisi.〕 Hospitals dominated the delivery system, with high bed numbers and very large numbers of medical personnel.〔
The Soviet system did not encourage economic diversification, leaving Georgia vulnerable after independence in 1991.〔 After the collapse of the Soviet Union, Georgia’s population decreased by nearly a fifth, the economy rapidly moved from a communist regime to a market system, and government corruption and civil wars tore the nation apart.〔Chanturidze, et al. 2009. “Georgia: Health system review.” ''Health Systems in Transition''.〕 Real per capita public expenditures on healthcare rapidly declined from around US $13.00 in 1990 to less than $1.00 in 1994.〔 The physical condition of facilities severely deteriorated, as did medical technology and equipment.〔 That is why, since independence in 1991, the nation has had to reestablish itself and reform many of its governmental structures, including its health care system. Georgia has made a significant effort to adapt health policy and the health system to the new environment. Mandatory social health insurance was introduced after independence, but was abolished after the 2003-2004 Rose Revolution, which brought about fundamental change in the role of government in providing, financing, and managing public services like healthcare.〔 Now, healthcare and health insurance are privatized.
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