Medical reform in Ukraine, which for several years officials announce, is finally beginning to grow into reality. The Ministry of health has put up for public discussion several bills, which are painted a scheme providing medical aid Ukrainians, writes UBR.
It is, in particular, the projects “On the state financial guarantees for providing medical services” and amendments to the Budget code in the part of the division of health care financing between the state and local budgets.
What is free and what is for the money
The Ministry of health proposes the introduction of two insurance packages.
The first is the minimum package will be fully paid for by the state. It will include:
- emergency assistance;
- primary care (family doctor);
- palliative care (to maintain the terminally ill).
Such insurance for the second half of 2017 will give everyone, without exception, the Ukrainians and even foreigners who reside in our country and in need of social support. In the framework of a minimum package of citizens will be available to all the procedures that are prescribed by a doctor — from analysis to treatment.
In fact, the bill does not specify the amount that will ultimately insure every Ukrainian. It will appear as soon as the Cabinet will calculate and approve the cost of medical services and manipulations. Meantime, just know that rates will be uniform for the whole country.
But will introduce more and correction coefficients, which take into account the “riskiness” of the patient (age, health status, etc.). Additionally, the hospitals promise to pay for the results in the treatment and prevention (for example, a high level of vaccination, mass screening (x-ray, mammography, etc.) of the population. A separate item on doctors are not permitted under any pretext to demand from patients money “by cash”.
In the insurance packet of the second type further includes:
- secondary care (specialists);
- treatment in institutions at the national level.
His promise to run until 2020. However, in this case, all the costs the state to take over will be gone. Provided joint and several payment of the money to make the patient.
The shares in which the state and ordinary Ukrainians will pay for this, to put it mildly, expensive treatment, the bill does not say, this nuance needs to elaborate the Cabinet.
For this package the cost of medical services will be different. The so-called joint rates of payment should also develop the government.
Where will treat
Ukrainians will be able to go with a new insurance, both public and private clinics, with whom the national health service will enter into contracts on health care of the population.
In parallel, the Ministry of health wants the law to prescribe that medicine will be paying the government, and that “hang” on local budgets. In developed by the Ministry of the amendments to the Budget code stipulates that the state Treasury will Fund primary care (family doctors) and public health (tuberculosis, cancer, cardiovascular disease, HIV/AIDS).
With local budgets it is proposed to remove primary care, but add costs for development of municipal institutions that provide such services. In practice, the “development” of polyclinics, clinics, medical points is including communal expensive repairs. The state will take over only part of the costs that will be included in the selectable regions medical subvention.
The grants, which are now calculated based on the number of population in a particular region, it is proposed to allocate based on the number of prisoners citizens of contracts on health care.
“It will eliminate discrimination, for example, labour migrants who are not registered in a certain locality, but constantly live there”, — specifies the Ministry of health.
The placebo effect
Experts estimate the idea of the Ministry of health skepticism. “Preparing a big Scam at the state level”, — said the President of the international Foundation “Health of Ukrainian people,” Sergei Soshinskaya.
And explains: the government should allocate to health at least 7-8% of GDP, and this figure does not exceed 4-5%. If we assume that the gross domestic product in 2016, a hole in the funding is simply huge — $ 2.7 billion. And this despite the fact that the state now officially recognizes that it is not able to pay for everything: x-rays, tests, MRI, etc. pay even in municipal hospitals.
If the government will nagnut EN masse to provide Ukrainians with free insurance, the money will need more. And their budget is clearly not enough, estimated Soshinskaya. Obviously, the government attempts to shift some costs on employers — they have to pay for insurance for their employees. But the budget is unlikely to pull even medical care for children, the elderly and the unemployed for whom, in fact, to pay no one.
“Most likely, the citizens of even minimal and formal free package will have to pay out of pocket on the spot. Moreover, the doctors no salaries were not increased, and to work for peanuts, they will not” — said Soshinskaya.
The representative of public organization “Medical control” Igor Shchedrin draws attention to technical shortcomings of the Ministry of health. In Ukraine there is still no standard protocols for the treatment of most diseases. But worldwide they are the basis for calculating the cost of insurance and tariffs. How are you going to believe us, and will not happen so that to the public trough will simply get access to “their” clinics that will be able to set inflated prices — still an open question.