Actual problems of insurance
medicine in Ukraine
The article is devoted to the actual problems of
introduction of insurance of
professional
responsibility of medical workers in the system of the Ministry of Internal
Affairs of Ukraine. There have been determined the key-tasks resolving of which
is possible if such an insurance is introduced. A list of circumstances that
are not considered by an insurer as insurance occassions which can’t be
subjected to indemnification is defined.
Before1989 the Soviet health system was
based on a curative approach and provided services to the entire
population. It was regarded as generally effective, as measured, for
example, by reductions in infant mortality from the 1950s and high
immunisation rates. Now, barely a third of Ukraine's infants are
vaccinated. Large reductions in expenditure on health care and in
access to services followed economic transition and have seriously
degraded the health system. Private purchase of health care exists
alongside a state funded system. Ukraine is currently seeking
international assistance to develop a system based on a combination
of tax and insurance.Public awareness of HIV risk is low, a consequence of the
government's neglect of public health. Lack of investment,
widespread poverty, social and judicial constraints on
decriminalisation of drug use, drug trafficking, and government
corruption have been key influencing factors.
Cultural attitudes toward injecting drug users, sex
workers, same sex relationships, immigrants, and people with
communicable diseases remain punitive. At the same time, the country
has experienced steep rises in injecting drug use, the initial
transmission route for HIV. Corrupt border controls and drug
trafficking have been internationally recognised features in Ukraine
until recently.
What is insurance medicine?
Treatment, even in the developed countries, is quite
expensive and not everyone can pay for it. In order to make it more accessible
institute of insurance medicine has been created.
The insurance
medicine is a form of public health services organization, which provides
obligatory state insurance upon illnesses in combination to private medical
practice and private medical institutions. Such system of the organization of
medicine allows putting a payment of medical staff and incomes of medical
establishments in direct dependence on quality of treatment and diagnostics.
And thus, from the financial point of view, reception of qualitative medical
aid is accessible to the majority of citizens.
The insurance
medicine means medical insurance which, in turn, can be obligatory or
voluntary. The world practice confirms that a basis of insurance medicine is
obligatory medical insurance. Its purpose is to guarantee reception of medical
service due to the saved up means in the insurance case.
Insurance fund is the main attribute of insurance
medicine. It is formed due to obligatory deductions of wages working,
deductions of employers’ profit, state grants and welfare funds.
The previous
Minister of Health of Ukraine has come out with the assumption, that 2-3 years
will be required for introduction of insurance medicine in Ukraine.
It is planned, that in a year 15,573 billion UAH will be spent on maintenance
of medical insurance.
In Ukraine
already the first experiences of application of insurance medicine appear.
Hospital cash departments may be considered as one of its prototypes. They
quite successfully work in many cities of Ukraine. But it is the form of
voluntary medical insurance. If to speak about obligatory medical insurance, it
is worth of mentioning that talks on its necessity have started already in the
beginning of 1990 – so long before occurrence of 49-th clause of the
Constitution, Ukraine guaranteeing to all citizens free-of-charge health
services. In 2002 the first bill about the state social medical insurance has
appeared. Later six more bills, offering to enter obligatory medical insurance,
have been submitted. But all of them have remained just projects. Next, these
days already the eighth bill On obligatory state social medical insurance has
been registered. On the basis of Fund of social insurance on time loss of
working capacity the project offers to carry out services of obligatory medical
insurance. Introduction of an innovation was planned for January, 1st, 2009.
Expenses for rendering of medical services will be guaranteed by the employer
(4,2 % from fund of a payment) and local enforcement authorities, and clients
will pay insurance payments regarding a covering of expenses for material
maintenance and social services of the Fund.
Reinsurance is
one of insurance kinds and the major mechanism on risks redistribution.
Reinsurance allows to compensate fluctuations and to reduce damage potential.
It is a system of economic relations according to which the insurer, accepting
to insurance on them (in view of the financial opportunities), transfers risks,
a part of the responsibility on the coordinated conditions to other insurers
with the purpose of creation of whenever possible balanced insurance portfolio,
financial stability maintenance and insurance operations profitability.
The Ukrainian
parliament passed a law in 1997 whereby all visitors to Ukraine are required to
obtain Ukrainian health insurance. The cost of this insurance depends on how
long you are in Ukraine. This required insurance can be purchased after arrival
and covers only the costs of basic medical care inside Ukraine; it does not
cover medical evacuation.