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Міністерство освіти і науки України

Національний університет «Києво-Могилянська академія»

Факультет правничих наук

Кафедра міжнародного права і спеціальних правових наук Есе

з курсу «Право та суспільство (англійською мовою)»

на тему: “Health care reform: what should be done for building a fully-fledged health system in Ukraine” Виконав студент 2 р.н.

2 групи ФПвН:

Григоров Денис Володимирович

Викладач:

Крахмальова Катерина Олексіївна Київ, 2015 in Ukraine is a successor of Soviet medicine, which was created in 1930-s and reached its peak after World War II, in 1970-s. [1]. In Soviet era, national healthcare system was mostly able to carry out its responsibilities, such as combating infectious diseases, providing medical services to remote regions, etc., but nowadays it is certainly outdated and very ineffective. The fact that 87% of Ukrainians are unsatisfied or poorly satisfied with quality of medical services speaks for itself [2]. Moreover, doctors themselves are discontented with our medical system: average doctor salary is lower than 300$. Even our closest neighbors are better in this perspective - average doctor salary is 800$ in Russia, 700-800$ in Lithuania, 1.500$ in Poland. [3]. Therefore, we can assume that existent healthcare system has proven to be ineffective, as suggested by discontent from both doctors and patients.need a profound systematic upgrade to change things for better. However, now, our country is in a middle of great political and economic crisis, and we have limited resources to spare for our healthcare system. Thus, the financial question remains the most difficult - where to get money? How to get enough money? How to spend them efficiently? In order to answer these questions, let us discuss main points of the health reform. Changing the distribution of funds We have inherited so called “bed system” from Soviet medicine. It means that hospitals are funded in accordance with the number of bed-places for patients. Such method has led to cases, when two hospitals, one overcrowded, second half-empty, but having the same number of bed-places receive the same amount of funding. Moreover, the number of bed-places per one hundred thousand citizens in Ukraine is twice bigger than in EU (950 and 500, respectively) [4]. This should certainly be changed. Funds should be allocated primarily not for the maintenance of hospitals, but for treatment of the patients. To spend these resources more efficiently, half-empty hospitals should fire some employees or even close. Saved money can be used, for example, to purchase expensive drugs for patients or to increase salaries of medical workers. Decentralization Back in the 1987, Madrid Declaration regarding professional (medical) autonomy and self-government reaffirmed the need for the medical profession to be self-governed. Consequently, EU adopted a series of laws, which allowed self-regulation and self-government of healthcare system. These laws outline organizational principles of professional doctors. In Ukraine, there is a law draft to the Law on medical authorities on 10/01/2014, which is still in discussion [5]. This bill introduces registry of medical staff, compulsory licensing of doctors, which would significantly increase the level of skills of our physicians and therefore increase the security level of the patient. In addition, implementation of medical self-government authority could really improve legal, social, financial and moral protection of the doctor and the medical profession. The introduction of health insurance According to the part 3 of article 49 of the Constitution of Ukraine, in state and municipal hospitals medical care is available free of charge. However, according to former Deputy Health Minister Volodymyr Zagorodny in 2014 the government spent 53 billion UAH on health care. Meanwhile, Ukrainians paid 30 billion UAH for medications and 9.8 billion - for unofficial, corrupt charges. This once again proves that the state "free of charge" medicine de facto does not exist., to prevent corruption and improve the quality of health services, health insurance should be introduced. Compulsory health insurance will allow all citizens of the country to receive high quality medical care. In case of complicated diseases, which require significant financial costs, and if the state, unfortunately, will not be able to provide the necessary funds for patient treatment, additional medical insurance institutions may help. It is with this combination of these two insurance systems that Ukraine will be able to build high quality modern medical system, so you will not have to bribe the doctor in order to be treated properly anymore. We must know what we are paying for. That is the main purpose of this reform., Ukrainian healthcare system, which is in the transition from a centralized command system to democratic, is in need of profound transformation. During this process, it is important to adopt positive international experience and take into account the mistakes that were made by other countries. Public-private partnership (PPP) National health care system is characterized with existence of serious problem and requires deep institutional, structural and functional reform. However, the possibility of change in this area is substantially limited with available financial resources of the state. The need to find new tools, methods and mechanisms of health care that can help deal with problems [6].of new sound management decisions, implementing new quality tools for their functioning, particular mechanisms,


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