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Іванческул Н., Medical Insurance: Problems and View ... - Форум

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Форум » Матеріали конференції 18.11.2011 » Охорона праці в Україні.. проблеми, досвіді перспективи » Іванческул Н., Medical Insurance: Problems and View ...
Іванческул Н., Medical Insurance: Problems and View ...
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Іванческул Наталія

Чернівецький торговельно-економічний інститут
Київського національного торговельно-економічного університету
м. Чернівці

Medical Insurance: Problems and View for Ukraine

The problem of health insurance is rather important on both global level and within single states and was reflected in the works by Rudoy and V. Polischuk. In their studies the researchers emphasize that "introduction of mandatory health insurance is a much more difficult task than the introduction of other types of social insurance that have already been established in Ukraine. It is concerned not only with ensuring the provision of appropriate social health services, but with the actual procurement of these services from relevant manufacturers and providing these services to the insured population "[2].
Insurance is the economic relationship under which the insurer as a result of cash contributions provides a third party with the amount paid by the insurer that holds a certain amount of responsibility and to ensure it fills up and effectively places the reserves, carries out preventive measures to reduce risk, and if necessary reinsures part of the latter.
The introduction in our state compulsory health insurance can become a cardinal step that can change things for the better . It should be mandatory, along with the already existing voluntary one. An adequate alternative to this step seems to be virtually absent. The experience of world leading countries shows that mandatory health insurance is a means by which it is possible to ensure the public's right to receive free quality care. Stetsenko says health insurance is a part of social security and has to ensure equal opportunities for citizens to obtain a medical and pharmaceutical care [1, 294].
Nowadays, quality health care is rather expensive for the majority of Ukrainian citizens, since an average Ukrainian citizen cannot afford to spend a significant part of the family budget for medical care. The Constitution of Ukraine, article 49 under which the state creates conditions for effective and accessible health care to all citizens, is not performed. It cannot be followed under existing conditions, and it's not a fault, but a national disaster of public health and medical workers.
Health insurance market has both positive trends, and a number of shortcomings.
Voluntary health insurance market in Ukraine is gradually evolving. In 2009 health insurance was tested and showed strenght to endure crisis under modern economic conditions. The fall in the segment of voluntary health insurance was avoided –sometimes employers paid contributions even at the expense of profits, as health and loyalty of staff is a key to the success of institutions especially in the period of crisis. In present-day reality, it is the only corporate insurance to show positive dynamics.
Despite positive trends in the development of voluntary health insurance, this segment is still very problematic. First of all most insurers are not willing to deal with medicine because they believe it is unnecessarily complicated and disadvantageous. In terms of insurance payments, the level of which is below 45-60%, causing the activities of domestic insurers to be practically on the verge of profitability. Ukrainians in their turn do not hurry to buy voluntary health insurance policies because these services remain quite expensive.
It should be noted that legislative authorities organs work out different variants of compulsory health insurance bill. Some offer to engage commercial agencies in the process of compulsory medical insurance (health insurance organizations) others believe that these powers should be delegated to the state.
State funds will obviously lack money for these payments thus employers will have to take part in the process.
The average policy offers 21,000 UAH, if a person has to be taken to the hospital. Otherwise the price is 16 000 USD (anol undoubtedly the price will depend on the insurance company insured).
If an individual wants to insure his/her child, he/she must be ready to choose amond the following options: first, insurerˈs refusal or, second, possible or not, or you will be denied by the insurance company or the too high price that is disadvantageous for the client.
Experts explain that children's health insurance is not profitable, because children often get sick. And, therefore, insurers do not want to deal with such cases.
Statistics shows that people are forced to pay themselves 40% to 100% of what the state allocates for medicine.
Ministry of Health predicts the introduction of compulsory health insurance in 2013-2015. All models of successful compulsory health insurance will have been studied by that time. The burden on the payroll under the condition of introduction of compulsory health insurance may increase from 4 to 12%. It may course business problems as it is problematic for companies to survive under such conditions.[3, s.99].
To develop health insurance it is necessary/advisable to:
1) raise salaries to medical staff;
2) open new medical centers equipped with modern medical equipment;
3) seek to ensure transparency of licensing and accreditation processes for medical institutions;
4) Medicine prising should be regulated by the state.
Thus, compulsory health insurance is widely discussed not only in the press, and TV broadcasts but in the legislative activity of the Verkhovna Rada of Ukraine. At the same time we should be aware there is no adequate alternative to this step. Joint efforts of all stakeholders must be directed to obtain a positive result, i.e. the introduction of compulsory health insurance in our state.
1. Stetsenko SG health law: the school. / SG Stetsenko. - Russia: Legal Center Press, 2007. - 572.
2. Rudy V. M. Medical insurance - not a panacea / VM Rudy, Polishchuk / / Weekly newspaper. - 2005. - № 48.
3. Bulletin. Lions. Univ Series Law. 2008. Vol. 46. S. 98-102
008. Vol. 46. S. 98-102

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