I jCan you do these tasks on your own?

	Yes	No	Need more practice
Talk about the structure and organization of Ukrainian health care
Define the main priorities of the Ukrainian health care system
Differentiate primary, secondary and tertiary medical care
Describe problems facing the health care system at present	1 1
Explain the demographic crisis in Ukraine
Comment on the reformation of Ukrainian health carc
List the obstacles preventing introduction of so­cial health insurance in Ukraine			1
Tell how the cost of care delivery can be covered

2. ! Give short information on the following issues.

• Organization of health care in Ukraine

• Influence of economic situation in Ukraine on health care coverage

• Transition to the new system of health care

• Access to and quality of medical care in Ukraine

• Epidemics and other medical problems in Ukraine

• Causes of demographic decline. Ways of solving this problem

3. ! Suggest your own conversation topic concerning health service in Ukraine.

A Bit of Humour

Student: “But I don’t think 1 deserve an absolute zero.”

Professor: “Neither do 1, but it is the lowest mark that 1 am allowed to give”.

A doctor was trying to check an epidemic in a village. Visiting a fami­ly, he asked: “Are you taking precautions to prevent the spread of contagion?”

“Yes, doctor,” replied the head of the family. “We’ve even bought a sanitary cup and all drink from it.”

More Reading

[ 1 Read the text and answer the questions.

1. What is the system of social system insurance aimed at?

2. What is the mandatory form of health insurance based on?

3. Who are the target premiums payers in social health insurance?

4. What steps have been taken in Ukraine to introduce social health insurance?

5. What transitional model of “budget insurance” was formed?

6. According to what principles should social health insurance be organized in Ukraine?

Fundamentals of Health Insurance in Ukraine

Nearly all countries of Central and Eastern Europe and all the Commonwealth of Independent States (CIS) including Ukraine ex­pressed their intention to turn to the system of social health insurance (SHI), expecting that insurance payments will permit to increase the overall volume of finance for the medical service. The mandatory form of health insurance based on social insurance principles guarantees medical care delivery on an equal basis and should provide social pro­tection for citizens in case of spending money on medical treatment. Social protection is assumed to create equal opportunities in getting medical care at the charge of SHI system in the volume and on condi­tions envisaged by health insurance schemes. SHI is characterized by public solidarity.

The classical model of SHI assumes that both employers and em­ployees pay target premiums. These will be used to cover the cost of care delivered to working citizens and non working members of their

families. As a transitional variant, because of economic instability in the CIS, the so-called “budget insurance” model was formed, which is intended to insure employees according to the above-mentioned scheme whereas the State is expected to ensure non-working citizens. In all these countries it is also planned to provide budgetary financing for activities in the sphere of public health, medical education, medi­cal research, etc.

Ukraine has already taken the first steps to introduce social health insurance:

1. The Parliament accepted the Fundamentals of Ukrainian legisla­tion on mandatory state social insurance (1998).

2. Verkhovna Rada has adopted in the first reading the draft of the Ukrainian Law “On mandatory state social health insurance” (2001).

It is intended to solve the following tasks via transition to social health insurance in Ukraine:

• attract additional financial resources to the health care sys­tem through SHI premiums to provide medical care to the population above the State’s minimum of guarantees;

• retain equality principles in health care and at the same time widen the consumer’s choice;

• increase the efficiency of resource allocation and use and remove structural inequalities within the health care system;

• improve the quality of care and consumers’ rights protec­tion;

• improve the level of health sector management.

It is suggested that social health insurance in Ukraine should be organized according to the following principles:

• universality, which becomes apparent in the form of compul­sory insurance of all citizens, as well as absence of individuals or population categories who are not allowed to the SHI system;

• social solidarity, i.e. the absence of links between the size of insurance premium and the insured person’s health status, redistribu­tion of financial resources in favor of the poorest and people with the worst health condition;

• economic efficiency and reasonability of health care that is defined by optimal use of health care resources from the point of view of receiving a maximal growth of final indicators of therapeutic and preventive activities, including per unit cost indicators of population health;

• State’s responsibility for the SHI system stability, which is ensured through SHI financial support and a set of regulative mea­sures to prevent steep fluctuations in medical care costs under SHI.

In contrast to the current budgetary system of financing, SHI will involve multiple sources of insurance premiums: payments by employ­ers and employees for hired workers; contributions from local budgets for children, disabled people, and other non-working people, state budget payments for the military.