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The adoption of bill No. 6327 by the Verkhovna Rada on October 19, 2017, can be seen as the start of reform in the healthcare system, which has been needed since Ukraine's independence.
The Ukrainian law stipulates the approval of principles and the volume of state funding (5% of GDP), a list of full coverage within the framework of industry standards in healthcare, the need for pricing services, the creation of a drug registry, and the creation of a unified medical information system.
The reform is planned to be implemented in stages from 2018 to 2020. The funding levels for each medical institution are planned based on the volume of services provided to patients.
The penetration rate of voluntary health insurance (VHI) in the Ukrainian market is no more than 5%. Basically, only employees of large companies, for whom a benefits package for employees is a significant competitive advantage in their HR policy, or individual solvent individuals can afford a health insurance policy.
One of the reasons for the low penetration rate of voluntary health insurance is the lack of willingness of existing healthcare institutions to cooperate with insurers. In my opinion, on the one hand, the state requirement for pricing services should encourage healthcare institutions to cooperate with all market participants willing to pay for their provision, especially with insurance companies.
On the other hand, different income levels will always require improved service conditions for those willing to pay for additional service and impeccable qualifications. Therefore, the combination of these factors should contribute to the growth of the voluntary health insurance market in general and among individuals in particular. Moreover, as incomes rise, the volume of voluntary health insurance will grow proportionally.
Some time ago, Olga Bogomolets, head of the Health Committee, published a price list on her blog for certain medical services for which the state will no longer pay after the reform. The price level, to put it mildly, is shocking to the average consumer. However, Deputy Minister of Health Pavlo Kovtonyuk commented that these are approximate rates for a pilot project of the National Academy of Medical Sciences, the Ministry of Health, and the Ministry of Finance—in reality, only four institutes of the Academy of Sciences—and that they will be paid by the state, represented by the National Health Service, to these medical institutions.
The state plans to pay for services in the healthcare system under the guaranteed package of services at no cost to the patient. Forming such a guaranteed package takes time.
Since 2018, free coverage of the following costs is already guaranteed for patients within primary healthcare:
By 2020, the healthcare reform should be implemented at the primary care level and will Tested as part of a pilot project by the National Academy of Medical Sciences, the Ministry of Health, and the Ministry of Finance. The rest will continue to operate as before.
During the phased reform of the existing healthcare system, the need for high-quality and prompt medical care will exist everywhere, because patients will need to be treated "here and now," regardless of the stage of implementation of changes in the public sector.
Currently, the desire of some healthcare institutions to receive payment for services through clear pricing or a charitable assistance system may lead to increased costs for patients, who will now be forced to pay bills to the cashier and strive to maintain their ability to pay for medical services.
During this transition period, the depreciation of fixed assets in healthcare institutions, the shortage of medical personnel of various levels due to low salaries, and the decline in the overall solvency of the population, in my opinion, will contribute to a decrease in timely medical care, an increase in the incidence of severe and critical illnesses, a rise in the incidence of infectious diseases with epidemics of certain nosological entities, and, ultimately, a low life expectancy in Ukraine compared to developed countries.
My long-standing conviction remains unchanged: despite all the ongoing changes, voluntary health insurance is the only alternative for the population to obtain clear financial protection and a guarantee of high-quality and prompt medical care. No one can take better care of themselves than they can themselves. To achieve this, they need to plan for potential expenses according to their income level and not wait for "manna from heaven," despite the temptations of government projects and their good intentions. Having a reliable "safety net" In the form of a health insurance policy and a reliable insurance company that will fulfill its obligations is simply essential these days.
Source: NV Business
Author: Irina Gevel (Head of the Board of the insurance company Alfa Insurance)
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