Armenia’s recently appointed Health Minister Levon Altunian has called for the legalization of informal payments to medical staff that have long been made by patients in the country.
Armenians visiting doctors at hospitals or state-run policlinics responsible for primary healthcare routinely pay them for medical aid or a consultation which is often supposed to be provided free of charge. The payments typically vary from 2,000 drams to 10,000 drams ($5-20) per visit.
“In 80 percent of the cases, the money is given to doctors as a gratuity,” Altunian told RFE/RL’s Armenian service (Azatutyun.am) last week. “In developed countries of the world there is a mechanism for making such payments legal. It doesn’t exist in Armenia.”
Altunian said his ministry will soon ask the government to levy a tax from such payments. The tax rate should be set at 10-15 percent, he said.
Some doctors criticized the proposed measure. One of them, Hay Manasian, said it would only encourage his unscrupulous colleagues to extort more cash from patients. “The money which a patient pays as a gift after successful treatment would be legalized so that their doctor feels free to accept it without fear,” he said.
Manasian said that the government should instead crack down on owners of private clinics who underpay their doctors and other medical staff. “Doctors are not paid enough and have to operate in the shadow,” he claimed.
Norar Davidian, a former health minister, also voiced serious misgivings about the extraordinary tax favored by Altunian. He said there is nothing inherently wrong with the informal payments because Armenians are a “grateful nation.”
Davidian also argued that the controversial gratuities are not always paid in cash and may take the form of flowers or a bottle of brandy, making their taxation very problematic.