The American Chamber of Commerce in Ukraine (the Chamber) has been actively urging the necessity to reform the healthcare system in Ukraine and stresses the importance of its further continuation.
People are the greatest wealth and the #1 priority for the state. During these challenging times of the coronavirus outbreak, the Chamber member companies mobilize their forces and help Ukrainians to fight against COVID-19 by donating money, providing services, medical equipment, and essential goods. Member companies believe that the patient and the quality of services should be at the center of the healthcare reform.
Reform of the healthcare system in Ukraine started in 2017 with adopted Law of Ukraine "On State Financial Guarantees in Providing Medical Care to the Patients", which has played an essential role in the healthcare system redevelopment in the country. For several years the fundamental changes were introduced:
- Governmental reimbursement program "Affordable Medicines" covering treatment of cardiovascular diseases, diabetes type II and bronchial asthma;
- National procurement conducted via international organizations brought more transparency, decreased prices and ability to procure more effective medical products, registered by the simplified procedure;
- The first successful stage of reform where almost all utilities have switched to a new funding model and started to obtain funds from the National Health Service for efficient and quality services provided. According to the EHealth, about 27 million Ukrainians signed the declaration with their family doctor. As a result of changes in the funding system, doctors' salaries have doubled and tripled.
- Transformations in medical education, linking traditions of Ukrainian medical education institutions to the Western standards.
The main principle of reform is "money follows the patient," where patients have their own choice of doctor and hospital. The reform moves away from the principle of funding for beds in healthcare facilities and increases incentives to provide better services. Thereby, approximately 40% of healthcare facilities have increased their budgets compared to last year's state and local funding. Another 20% of hospitals have a larger budget than the medical subvention.
The Chamber members believe that competition for the patient will motivate hospitals to develop, effectively invest in new equipment and management, increase doctors' salaries, and improve service delivery. We believe that it may help to overcome high mortality rates in Ukraine (for example, the mortality rate in Ukraine is 14.5 per 1K people vs 11 per 1K in Poland, 2019; and mortality from cardiovascular diseases in Ukraine is 908 per 100K people vs 477 per 100K in Poland, 2019; data – IQVIA).
Increase governmental spending on value-based healthcare significantly (targeting the EU level) is one of the highest priorities for the Chamber. According to the data of IQVIA, state healthcare expenditures in Ukraine in 2019 is 3,6% of GDP. Meanwhile, Eastern Europe countries reached 6.2% of GDP in 2020. We welcome the initiative on increasing the budget spending on healthcare and repeatedly stressed the need to increase the level of healthcare funding as stipulated by the Law of Ukraine "On State Financial Guarantees in Providing Medical Care to the Patients" not less than 5% of GDP. We support such an increase in funding but insist on its efficient and transparent distribution and use.
The American Chamber of Commerce in Ukraine urges President of Ukraine Volodymyr Zelenskyy, Prime Minister of Ukraine Denys Shmyhal, Minister of Health Maksym Stepanov and Members of Parliament, in particular, Head of Parliamentary Committee on National Health, Medical Care and Health Insurance Mykhailo Radutskyy to continue the healthcare reform in Ukraine and to preserve its new financing model that started on April 1st.
