Politics is the art of the possible, and it is always necessary to make choice in it. It often happens that it is necessary to choose not from the good and the better, but from the lesser of two evils. And then, it is necessary to decide, which one of these seeming evils in near-term outlook are really evil and which one will do good.
The life expectancy at birth in Ukraine is one of the lowest in Europe. Based on this index in the international rating of the World Health Organization, our country is 104th among all countries of the world, being between Surinam and Kyrgyzstan.
The level of real, not pretentious accessibility of medical services for the population is also extremely low. Even the governmental programme “Accessible Medicines” didn’t change the situation significantly. That is why I think that to leave the health protection system in its current condition is a bigger evil than to try to reform it, even by way of some unpopular measures.
Whatever beautiful is the constitutional utopia about the guarantee of free health care for all citizens of Ukraine, this provision was never implemented. The current economic situation just does not allow the state to guarantee it, and, generally speaking, it has never allowed.
Moreover, it will not allow it in the foreseeable future. So, do we really need to stick to this article and to turn down the necessity of medical reform from the populist position? In fact, Ukrainians pay for this “free health care” twice: first, with their taxes and fees filling the budget that provides funding to hospitals, and second, when they visit a doctor.
The transition to the principles of effectiveness and quality of the system of health protection may be painful, and the critics of the reform warn about it. It is planned to introduce the mechanisms of competitive market, under which the wages of doctors will depend on the number of its patients. The expenditures on the health protection system will be partially covered with the insurance system. Moreover, the government expects that thanks to the medical reform the system of health protection will receive additions $25 billion during three years. And this means the wages for doctors, the equipment and generally the new quality of services.
Perhaps, the reform adopted by the Parliament is far from ideal, but it is a huge step towards the qualitative changes in our system of health protection. There will be a step-by-step reformation, and the law guarantees protection mechanisms for those citizens, who are not able to pay for medical services. Nevertheless, it is time to forget the illusion of “free system of health protection.” It is always necessary to pay for quality in market economy. And if we want our children and grandchildren to live longer and better than we do, the model of insurance medicine must be launched in Ukraine, and the law passed on October 19 will only contribute to it.
