Reform of the health care system in Ukraine is one of the most complicated areas of state policy at present. With the aim of assisting the reform of the health care system in our country and raising it to European standards, the Health Care Committee of the European Business Association* initiated “The Medical Insurance and Reform of the Health Care System in Ukraine” project, which for almost two years now has been working actively with the Ukrainian Health Ministry and with leading Ukrainian and foreign experts.

During implementation of the project:

• Analysis was carried out of models of financing the health care system, and an evaluation was carried out of the state of legislative provisions and legislative initiatives in the health care field;
• Public monitoring was carried out of the above-mentioned problem (discussions were held with representatives of state institutions, socially responsible companies and public organizations);
• A vision will be created as regards the creation in Ukraine of an understandable and effective system of medical insurance founded on world standards of medical and health care provision.

The First International Conference “Medical Insurance and Reform of the Health Care System in Ukraine” was held on Tuesday 15 April 2008 within the auspices of the said project. First and foremost, the conference was dedicated to explaining ways in which the health care system can be reformed and which concern every single Ukraine, as avoiding the risk of falling ill remains a priority. Regardless of the fact that financing of the health care sector in Ukraine is rising at the present time and the country rates very highly in terms of numbers of doctors and hospital beds per capita, we find ourselves near the bottom of the table in terms of quality of medical services and treatment.

The Health Care Committee of the European Business Association took this initiative upon itself in order to assist in prolonging dialogue between business and the authorities by bringing their general attention to difficult global issues of the health care sector and proposals on how to resolve them.

The issue of moving to another model is a question of effectiveness and not money. The participants of the conference received a UNIQUE OPPORTUNITY to hear answers from local experts and their colleagues from Poland, Finland and Moldova to questions which are extraordinarily topical for Ukraine today.

The following themes were raised at the conference by experts of the system of mandatory social medical insurance:

• The experience of the three reporting countries (Poland, Finland and Moldova) regarding this issue;
• The situation regarding mandatory social medical insurance in Ukraine and the prospects of introducing it;
• The legislative initiatives of the Ukrainian Parliament as regards the stated issues;
• Standardization of medical assistance and provision of medicines in the mandatory social medical insurance system.

The following Ukrainian and foreign experts gave their views on a range of acute issues regarding mandatory social medical insurance:

• Tetyana Bakhetyeyeva, Head of the Ukrainian Parliamentary Committee for Health Care;
• Viktor Rybchuk, Ukrainian Deputy Health Minister;
• Georg Russu, General Director, National Medical Insurance Company of the Republic of Moldova;
• Vasille Paskal, Deputy Director, National Medical Insurance Company of the Republic of Poland;
• Anatol Golab, Deputy Director, Department for Medical Insurance, Health Ministry of the Republic of Poland;
• Piotr Kulpa, Director, Department for General Issues, Health Ministry of the Republic of Poland;
• Eero Linnako, expert for financial issues and hospital planning, EU project «Assisting reform of secondary medical assistance in Ukraine» (Finland);
• Dmytro Karamyshev, local expert;
• Оleh Vinohradov, Ukrainian Parliamentary Committee for Health Care;
• Аlla Stepanenko, project manager, проект «Support for the development of systems of medical standards in Ukraine» project.

Welcoming the participants of the conference, Tetyana Bakhetyeyeva thanked the organizers of the conference for the fact that the holding of the First International Conference “Medical Insurance and Reform of the Health Care System in Ukraine” had finally been initiated. «It is very important that we are together today and we have a unique opportunity to study successful international practice. At the present time we, as never before, are striving to ensure that a law on mandatory social medical insurance in Ukraine is adopted as soon possible. At the present time there are three draft bills on medical insurance systems registered in the Ukrainian Parliament. However, taking into account many factors, including the international experience of our colleagues, we would like to note that none of them are capable of resolving the problems of patients and employees of the medical branch» Tetyana Bakhetyeyeva.

Viktor Rybchuk stressed: «Today, the health care system in Ukraine is displaying inequality in access to medical services on the part of the population. At the present time we feel an acute need for reform of this system. We plan to develop the first pilot project on the introduction of mandatory social medical insurance and reimbursement. We hope that international experience will safeguard us from many mistakes».

Georg Russu presented the model of mandatory social medical insurance introduced in Moldova, which significantly reduced the mortality rate of socially unprotected strata of the population and increased the salaries of medical workers by 3-4 times. «At the time when the system of medical insurance was introduced in the Republic of Moldova no-one was able to guarantee us success and very few people believed in us. Fortunately, this risky project turned out to be a success for us. It has been working successfully for five years and, most importantly, without any breakdowns in its operation. In this period the levels of infant mortality and mortality rates of mothers as well as deaths from cardio-vascular illnesses have all fallen markedly. Today the system of mandatory insurance does not raise any issues, it is an axiom» Georg Russu said. 

Anatole Golab presented the successful experience of Poland to participants of the conference, as a country which only recently become a member of the European Union and which spends three times more money on health care than on defence. Piotr Kulpa shared with participants certain problems of the insurance system as encountered by Poland. «In my opinion, health care in Poland is the most important sector of the country’s economy. It should be understood that in the system of insurance it does not matter who pays for the services. The main task is to create such a mechanism whose operation would ensure that each patient feels himself or herself equally protected» - Mr Kulpa said. 

Eero Linnako illustrated the operation of the Finnish social insurance system in figures and outlined its achievements. «A system of insurance is, without doubt, an integral part of a successful country. We can state that there has been a significant fall in mortality rates for men, women and, what is very important, for infants, over the last 20-30 years. In the 1980s the infant mortality rate in our country was the highest in the world, but now it is up to 4 %.  According to the findings of independent research carried out by one European institute, the population of Finland is very happy with the insurance system which was introduced. This relates to the quality of services, the level of spending and the standard of living», Mr Linnako said.

The conference was held at the conference centre of the Prezydent Hotel Kiyiviskiy located at: Hospitalna St.

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