Political discussions about continuing the healthcare reform, which have been lately heard from the highest officials, cause serious distress about the timely start of the secondary (specialized) medical reform. Information about the system allegedly being “unready” for the reform is spreading rapidly making it easy for manipulation to spread and might cause a possible decision to delay the reform or to revise its model.
Legislation of Ukraine “On the State’s financial guarantees of healthcare to the population” (2168-VII) states April 1st 2020 as the starting date of the secondary grade reform. At the basis of the entire transformation of the healthcare system is the change in the financing model as well as realization of the principle “money come after the patient”. For specialized medical care it means that the State will pay through the National Health Service of Ukraine (NHSU) to the medical institution for a specific medical service, a medical emergency or willingness to provide assistance. In addition, a patient can choose a hospital for receiving medical care regardless one’s official place of registration or address.
Under this funding model, hospitals will not receive funding for an objectively inflated number of beds, economically unreasonable living expenses, and staff overcharges. Meaning the reform predicts a more efficient use of the budget in the healthcare field and stimulates an increase in the quality and availability of the medical services for patients. This is extremely important in organizing the healthcare system, given the fight against COVID-19 coronavirus infection. Also, direct contracting of institutions and the use of electronic tools will improve hospital management and response to the epidemiological situation.
However, delaying the reform will leave the secondary grade in its current state: the medical personnel will keep receiving low wages, patients will keep paying for medical services from their own pockets and the corruption will stay intact.
As of March 17, 2020, 1769 medical institutions applied for contracts with the NHSU, which signals of them being ready to receive funds according to the new financing model. The level of autonomy of secondary level establishments as of this date is 99%. That is, patients can be assured of the capacity of the national network of healthcare facilities to provide medical care and the ability of the NHSU to pay for each referral to a narrow specialist (outpatient or inpatient), with or without referral from a family physician (in urgent cases).
The reformed model of solidarity health insurance with emphasis on universal access to healthcare does not burden citizens with additional taxes, but all patients have equal access to the health guarantee program. The program is financed from the State budget (from taxpayer funds) through NHSU, the only state customer of medical services that performs the functions of a state insurance company.
The RPR Coalition urges the Government and the NHSU to start specialized care reform starting April 1st, 2020, which is consistent with current legislation, the strategic goals of the reform and the right of every citizen to health care.