“When health is absent, wisdom cannot reveal itself, art cannot manifest, strength cannot fight, wealth becomes useless, and intelligence cannot be applied.”
This statement by an outstanding ancient Greek scholar underlines the importance of the healthcare industry for every person, irrespective of age, gender, ethnicity, and religion. Healthcare issues can be called without exaggeration a matter of life and death in Ukraine, as our medical industry is in a terrible crisis now. Harsh debates about the reform of the medical industry, both in politics and in society, have been lasting for years; everybody is pulling, but nothing is moving. But lately, things have become worse, the industry has gone into decline, and citizens often cannot even receive first aid. Not even mention innovative medical services.
The population of rural areas and small towns suffer the most. In fact, city communal hospitals and clinics do not possess a modern level of service, innovative equipment, and decent conditions for their patients. The only advantage here is that the city people have an opportunity to be treated in private medical institutions, where they diagnosed and cured, of course, they would be forced to pay a lot of money.
Budget medical institutions are still not competitive with the private clinics; because of the lack of sufficient funding, they just cannot buy modern diagnostic equipment, without which a western doctor simply does not imagine his work. Due to the lack of means, the conditions of the Ukrainian hospitals are also of a very low standard. And one more problem is the acute shortage of qualified personnel. This applies to both nursing staff and doctors.
Why did this situation arise? The fact is not only the medical industry as such is in the doldrums, but also the system of training of future specialists. And although the competition in medical institutes and universities is still astonishing, after receiving diplomas many graduates try to avoid working in the hospitals but are trying to find a job in various companies that have little to do with practical medicine itself.
The explanation is simple: the salaries are higher there. After all, the salaries of Ukrainian physicians do not stand up to scrutiny. Meanwhile, our qualified specialists are happy to invite foreign clinics, offering them decent wages and excellent working conditions in the well-equipped hospitals.
How can we overcome all these adversities and finally create a normal healthcare system? The problem is complex; it has been neglected for a long time and can be solved by magic only. One thing is clear: this clumsy bureaucratic colossus will not start working by the European standards at once. First of all, we do not have the necessary experience. But don’t we use the experience of those countries that have managed to build a simple and affordable medical system, providing the necessary services to the entire population of the country. This refers to insurance medicine.
Insurance medicine is in an embryonic stage in Ukraine because the country has only the so-called voluntary medical insurance. For example, in Germany, the first law on compulsory health insurance for working people appeared in 1883 and became mandatory for the whole country. And in Bavaria (a separate land with its own authorities), insurance medicine has existed since 1869! Actually, the provisions of the German legislation were taken as a basis for the health insurance in most of the European countries.
Long discussions and attempts to create in Ukraine something similar to those medical institutions that exist in most developed countries did not give any positive results.
However, let's not ask an eternal question of who is to blame, but let us try to understand what could be done in order to overcome all obstacles and take the first steps to create a viable health care system. And if they are successful, people will finally believe in the effectiveness of the medical reform in Ukraine.
These were our ideas, that is why we are elaborating bill No. 9163. Now the document is under consideration in the Verkhovna Rada committees, and we hope that it will be adopted by the end of this year.
What is this document about? First of all, it clearly sets the rules of the game. The basic program provides a list of the medical services that could be received by the citizens of Ukraine, foreigners citizens, and stateless persons at the expense of budget funds. First of all, this is first aid at the level of life preservation and partial healthcare.
Now regarding the compulsory health insurance program. The bill states that medical insurance in Ukraine is a form of “financial support for Ukraine’s population, which might be incurred for treatment, diagnosis, prevention, rehabilitation, provision of medical supplies in the event of illness or accident, within the limits defined by the Program insurance, at the expense of cash funds.”
We cannot ignore the situation regarding the sources of funding and control over the funds. All the finance of insurance reserves is supposed to be placed "in the state banks with regard to safety, profitability, high liquidity, low risk, and diversification..." A special authorized body to carry control over the accounts in which the above funds are placed.
And yet, I focus your attention on the term "prevention." In my opinion, this is an extremely important aspect of medical care, because it is always easier to prevent a disease than to treat a neglected one. As the distinguished surgeon Pirogov (prominent Russian scientist, medical doctor, pedagogue, public figure – Ed.) rightly has noted, "...the future belongs to preventive medicine. This science, going hand in hand with the statehood, will bring undoubted benefit to humanity."
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