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The state admitted that there is no money in the budget for all medicine
In the fall of 2017, the parliament adopted a law on financial guarantees for medical care for the population. In short, its essence is that the state is ready to allocate 5% of GDP to medicine. The health care budget will be determined by the parliament every year. The Verkhovna Rada will approve which medical services the budget will cover and which will not. This means that part of medicine will become paid. According to the law, this will be no more than 20% of medical services. This will be clear in more detail in the fall, when parliamentarians will adopt the state budget for 2019. The medical reform itself is designed for 2020. Therefore, paid medical services will be implemented gradually.
Paid medical services can be covered at your own expense or through voluntary medical insurance. And now insurance companies have slowly but gradually begun to offer Ukrainians voluntary medical insurance (VMI) policies. Six months ago, it was practically impossible to buy an individual VHI policy.
Are insurance companies ready to pay for the treatment of Ukrainians and on what terms, the website "Segodnya" investigated.
There are several options for insuring yourself, your life, health, and work capacity. Therefore, there are the following types of personal insurance:
In what cases are they used? Medical insurance is used mainly to cover the costs associated with emergency medical care when traveling abroad. Medical insurance, unlike other types of personal insurance, provides the insured with the medical care service itself, and not with payment as a result of an insured event, as is the case with health insurance in case of illness or accident insurance, explains Andriy Basarab, Head of Product Management and Methodology at "AXA Insurance".
Today, only 5-6% of Ukrainians have a VHI policy. The market itself is at the initial stage of development. The development of medical insurance until 2017 was hampered by the unreformed healthcare system.
Insurers mainly offer VHI to work teams – that is, an employer can arrange it for its employees. After the start of the medical reform, some insurers began to offer individual VHI policies - while they are available in large cities. But before that, the insurance company must assess the risk and form an insurance tariff. To do this, a person must undergo a medical examination at his own expense. The cost of individual VHI is 4-5 times more expensive than corporate and ranges from 20-30 thousand UAH., in addition, insurance will be limited by a large number of exceptions and limits on medications compared to corporate programs, insurance companies note.
Currently, 90% of the entire personal insurance market is in the corporate segment, says Raisa Atamanenko, director of individual types of insurance at SK "Kraina". The share of insurance in case of illness is no more than 2%.
In private clinics, the goal is often not to cure a person, but to provide them with more expensive services. Therefore, the cost of a policy for an able-bodied Ukrainian is 10-15 thousand UAH per year, says Andriy Besarab. Municipal medical institutions are in no hurry to cooperate with insurance companies.
Now insurers offer corporate VHI policies for a simple reason - very sick and weak people will not work in the team. Employees will never get sick. Insurers calculate their programs for this. And if everyone is allowed to be insured one by one, then only the sick will go for policies, shares an agent of one of the insurance companies. VHI will begin to develop when a database of all patients appears in Ukraine. Then the insurance company will be sure of the health condition of the person coming to it.
"When there is an all-Ukrainian database with confirmed diagnoses of people's medical histories - these policies will be individual, each will have its own conditions and prices, and then everyone will be accepted for insurance. While a certificate for any disease in Ukraine can be purchased for 200 UAH via the Internet, insurance companies will not deal with individual VHI", - an insurance agent told the "Segodnya" website.
The availability of voluntary health insurance depends on the healthcare reform.
"Today's reform is aimed at covering the most necessary - this is primary medical care, a family doctor, a therapist or a pediatrician. Companies that can find a symbiosis of state and private insurance will occupy the niche of services that are necessary and recommended by a family doctor, but are not guaranteed by the state as part of the reform", Bessarab adds.
Every year the market for voluntary health insurance grows, says Raisa Atamanenko. Firstly, the requirements on the labor market are increasing, employers are trying to retain employees by offering corporate health insurance. Secondly, the population's trust in insurance companies is growing.
But the offer of voluntary health insurance is very uneven - it is poorly developed in the regions.
This is due to the low solvency of the population and the state of the country's economy, the unwillingness of state medical institutions to work in the VHI system and the small number of private medical institutions.
"In general, insurance companies are waiting for the first results of the medical reform. If it launches mechanisms for civilized interaction between insurance companies and state medical institutions, many Ukrainians in the regions will be able to enjoy the benefits of VHI", - adds Atamanenko.
Insurance will become affordable after the introduction of mandatory health insurance, when insurance companies will insure a large number of people for whom they are guaranteed to receive an insurance payment. At the same time, not selectively - only the sick - but all citizens.
To date, all well-known insurance companies that have introduced individual insurance have suffered losses on such projects, Atamanenko summarizes. An insurer that has a large portfolio of corporate clients or a new player on the market who is ready to work with losses for several years can afford to engage in retail insurance.
Source: TODAY
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