[Can people afford to pay for health care? New evidence on financial protection in Georgia]

This review is part of a series of country-based studies generating new evidence on financial protection in European health systems. Financial protection is central to universal health coverage and a core dimension of health system performance. Georgia has a relatively high incidence of impoverishing and catastrophic health spending compared to other countries in Europe. Catastrophic spending is driven mainly by out-of-pocket payments for outpatient medicines, but also for inpatient and outpatient care. It is heavily concentrated among the poorest households. Although reforms introduced since 2013 have improved access to health care and reduced the health system’s reliance on out-of-pocket payments, public spending on health remains low and gaps in coverage persist. To strengthen financial protection, increased public investment in health – especially in primary health care – is necessary but not enough. The government should also address gaps in coverage by prioritizing better protection for poor households and people with chronic conditions; introduce stronger regulation of service volumes and prices (including medicine prices) to ensure resources are used efficiently; and improve the quality of primary health care.