CURRENT TRENDS AND THE REALITIES OF HEALTH CARE FINANCING IN UKRAINE

Lesia Zinoviivna SHUPA

Анотація


Introduction. The market transformation in Ukraine require qualitative changes in the health care system, which restricted government funding under the impact of the crisis had a negative impact on the development of its infrastructure, the level and quality of medical services. The real alternative is the introduction of budget financing of health insurance that can provide new sources of funds to health and thus create the conditions for quality health care. So urgency is the study of modern trends in health care financing in Ukraine and to explore new economic realities for the introduction of obligatory and voluntary health insurance.

Purpose. While acknowledging the operating time scientists note that until now remained unresolved problems associated with inefficient mechanism for financing health care. So important today is to study the current state of Ukrainian medicine financial security and identification number of negative trends in its development, which is the purpose of the article.

Results. Considering the dynamics of total health care costs, we can note an increase of the amount for 2008-2014 years 63,072,700,000. USD. to 117.7546 million. UAH. (By 186.7%), while irregular dynamics in which the growth rate for the 2010-2014 decline (from 113.2% in 2010 to 101.7% in 2014). However, increasing the size of health care financing in 2014 did not provide a guaranteed amount of medical care, because the growth of the dollar exchange rate of hryvnia to 7.99 (in 2009-2013) to 11.89 (in 2014) led to a decline in income, and an increase in prices of medicines, medical supplies, medical equipment - to the rising cost of medical care.

Financial accessibility of care, purchase of medicines and medical devices depends on the financial viability, on the one hand, the state invest the development of health from the budget in the main to provide it guaranteed volume of free medical care, the other - household members pay medical services that are not included in publicly guaranteed amount of public medicine. Thus, the main sources of funding for the national health system are: state (public) funds, which cover the budget, social security funds, funds of public companies; private funds - funds from households, commercial and non-profit organizations; means another world - funds from international donor organizations aimed at Ukraine's health system.

On the reduction of budget resources as the main source of financial provision of healthcare, as declared in the Constitution of Ukraine, leads to a reduction in financial access to care and quality of emergency medicine, violated the human right to free of charge medical services, particularly for the most vulnerable, the poor.

In the years 2008-2014 Health Management is financed by public funds, whose share in 2014 reached 99.9%. Negligible share of the funding sources occupy donor funds (0.1% -1.3%). Note that this feature provides healthcare than public health and medical insurance. Note that this feature provides healthcare than public health and medical insurance. Note that the compulsory health insurance is not introduced in Ukraine, voluntary form his organization takes a tiny fraction, and funding for health management at the expense of public funds. 

Conclusion. Summarizing this study current trends and realities of health financing, we note that the first, the most important issue of national health care system is the lack of funding, inefficient use of funds allocated to the state, the imbalance in the structure of health care financing in the limited budget funding. These negative trends associated with the negative impact of the economic and political crisis, lack of coordination between the amount of state-guaranteed free medical care and the budget allocated for its provision, low-income and increasing risk of loss of life and health, inefficient development of voluntary health insurance. 

To solve these problems, it is appropriate priority is, in our opinion, the introduction of compulsory health insurance as an effective tool to attract financial support for the health sector. In addition, improving the functioning of voluntary insurance market, which in conditions of financial and political crisis characterized by negative phenomena and processes related to low levels of solvency and welfare, minor financial capacity and reliability insurers inadequate legal framework and the lack of tax incentives for the development of health insurance, low quality of insurance services anderaytynhovoyu and ineffective policies, serve the growth of quality of care, reduce social tension and the emergence of social conflicts.


Ключові слова


finance; healthcare; Consolidated budget expenditures; sources of financing; general expenses; health aid; budgetary resources

Посилання


Lobodina, Z. M. & Lopushnyak, G. S. (2014). In V.G. Demyanyshyn (Ed). Financial aspects of investment and innovation development of health care. Ternopil : The financial policy of investment and innovation development of health care: a monograph. (in Ukr.)

State Statistics Service of Ukraine (2016). National Health Accounts (NHA) Ukraine in 2014: Statistical Bulletin. Retrieved from http://www.ukrstat.gov.ua. (in Ukr.)

Budget Ukraine (2008-2014). Reports on the State and local budgets of Ukraine for 2008-2014 years. Retrieved from http://www.treasury/gov.ua. (in Ukr.)


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