Healthcare refom: Step forward or liquidation of welfare state in Ukraine

Author : News Agency 112 International

Source : 112 Ukraine

The main essence of the reform is the actual cancellation of guarantees for the provision of free medical care
18:53, 20 October 2017

Open source

The Verkhovna Rada of Ukraine adopted the draft law #6327 in the second hearing and as a whole that implements the first stage of the medical reform. 240 MPs supported the document. 

The draft law was significantly changed during the improvement for the second hearing.

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The main essence of the document is the actual cancellation of guarantees for the provision of free medical care. Article 49 of the Constitution of Ukraine states that everyone has the right to health protection, medical care, and medical insurance. From this point forward, actually, Ukraine has cancelled free medical care. But let us look in details.

Free medicine - at the primary level

After the entry into force of the medical reform, first aid, primary health care, and palliative care will remain free. On other words, the "family doctor" or a pediatrician freely consults and provides first medical aid. This doctor can also give a painkiller to those who suffer severe and fatal diseases and need pain reduction.

Treatment of military wounds will be additionally free for Donbas veterans.

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A full package of free services will be annually registered by a new body - the National Health Service and approved by the Cabinet of Ministers.

Сo-payed child-bearing and some other medical services

The second type of service is co-payment, when a part is paid by the state, the other part - by the patient. This was a controversial article, the amendments to which were considered for three days in the session hall. As a result, the principle of co-payment was approved by the deputies. The price for similar services will also be controlled by the new body. Donbas veterans do not participate in co-payment (the entire list of additional services is paid by the state for life).

The medical services that will not be covered by the state and enter into a guaranteed package will be paid.

And here is the main problem. There are no lists of these medical manipulations. In other words, citizens are provided with free medical services that will be included in the program of medical guarantees, but no one knows what this program, actually, includes. What is known for sure, "second level" means the co-payment: medical examination, operations (for example, removal of appendicitis), childbirth.

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An uncomplicated pregnancy will be observed for free by the family doctor. In case of complications, the highly specialized medical care of a gynecologist will be provided on the principle of co-payment. The doctor will diagnose and offer a list of treatment for free, but you will have to pay for medications and so on. The same applies to childbirth. The child-bearing itself, if it proceeds without complications, will be free of charge, but all additional services - medicines, cesarean section, ward - will be paid by the woman in childbirth. She will also have to come to the hospital on her own.

At sole cost and expense

Highly specialized medicine (the so-called "third level") will be fully paid by the pacient – traumatology, cardiosurgery, neurosurgery, etc.

Former Healthcare Minister, deputy of Ukraine Olha Bohomolets shared approximate prices for medical services of the “third level.”

Diagnosis of child’s heart rhythm disturbances will cost 2,5 thousand USD. Reprosthesis of two heart valves - almost 7,3 thousand USD. Heart aneurysm - almost 6 thousand USD. Stenosis - more than 6,2 thousand USD. Shunting the aorta - 130 thousand hryvnia. Coronary artery thrombosis - 4 thousand. Treatment of liver cirrhosis – 4,2 thousand.

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The cheapest operation in this list is the removal of boils (270 USD). Removing of the stone in the gallbladder will cost from 1,3 to 1,9 thousand USD. Treatment of acute pancreatitis - almost 2,8 thousand USD.

Among the other innovations of the reform is 'Money Follows the Patient' principle. For each patient, the doctor will be paid an average of 14,2 USD per year. Each hospital needs to collect at least 2,000 patients. It is already obvious that such an innovation will leave the inhabitants of remote settlements without medical care. The consequence will be the complete destruction of medicine in Ukrainian village.

Another novelty is creation of "telemedicine" - providing advice to residents of remote villages via the Internet. Taking into consideration the fact that many villages do not even have 3G internet and assess to cable internet at all, this innovation is really dubious. It can be assumed that due to strong corruptional traditions in Ukraine, money allocated for implementing of this point of reform would be just stolen.

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