
Feb
28
Ukraine Debating Health Insurance Reform
Posted on Feb 28, 2011 by Sergio Ulloa (G+)
Several prominent Ukrainian based private insurance companies have disclosed that a state health insurance scheme could be introduced to the Ukraine as early as 2014. The discussion on healthcare and insurance reform has been brought forth following Deputy Parliament Speaker Tetiana Bakhteeva's prediction that the Ukranian health system will be ready for a comprehensive health insurance option by 2014. Since independence from the former Soviet Union, Ukraine has undergone a dramatic demographic decline and health crisis. The central European nation has the fastest rate of depopulation on the continent, with a third of all Ukrainians dieing prematurely before the age of 65 years. Political flux, including frequent changes in the Ukrainian government and the leadership of the Ministry of Health have led to protracted delays in institutional change in the health system and the reorganization of ambulatory health care. Ukraine's development into a more modern insurance driven health care sector has been further maligned by the financial crisis of 2007 - 2010 which has seen the value of their currency, the Hyrvina, fall when utility costs across the board are rising. Voluntary health insurance presently plays a very insignificant role in Ukrainian healthcare financing; voluntary health insurance serves to supplement government provided health services within the country. Mrs. Bakhteeva, who chairs the parliamentary committee on health, has advocated for a state-sponsored insurance medical system. Olena Tarovska, the Director of the Department of Sales for Personal Insurance at Oranta Incorporated, revealed that "compulsory health insurance in Ukraine may be introduced in Ukraine in 2014. I think that the leading insurance companies in Ukraine will participate in organization and implementation of this project." Mrs. Tarovska further believes that health insurance in Ukraine should be mandatory for emergency services, and for providing time-sensitive ambulatory aid. Voluntary health insurance plans would be offered for additional medical operations. "Because a sort of tandem between compulsory and voluntary health insurance will be created if compulsory state insurance is introduced," she said. The administration and financing of the proposed compulsory health care services could in fact be provided by accredited private insurance companies. If private firms do take on this burden, only the model of insurance payments would need be adjusted. A unified regulatory agency for compulsory medical insurance could be created to monitor finance, distribute cash flows, and oversee the quality of services. According to INGO, one of Ukraine's major private health insurance providers, the introduction of a compulsory health insurance scheme could be possible in 2014 or 2015. Hennadii Mysnik, a Deputy Board Member of INGO Ukraine, has stated that "the prospect for introduction of compulsory health insurance in Ukraine will become a reality no earlier than three or four years," he said. Mr. Mysnik, maintains that the persistent under-funding of the health care sector has been the catalyst for the introduction of a compulsory health insurance scheme in Ukraine. The factors now preventing its implementation involve financial management and responsibility issues, and are not about what would change for the patients and practitioners in the Ukrainian health care sector. Whether the public itself is ready for introduction of compulsory health insurance is another issue entirely. NATSA, a Russian health insurance company and subsidiary of Zurich Financial Services, has reportedly been involved in discussions with the Ukrainian government regarding healthcare reform for the past 15 years, according to Halyna Bobyr, NASTA Insurance's Deputy Director for the Department of Underwriting and Methodology of Personal Insurance. During this period dozens of preliminary draft laws on compulsory health insurance have been discussed, many of which have been registered in the parliament. Mrs Bobyr is of the opinion that drastic reforms are needed within the Ukrainian healthcare sector, stating that she believed "that Ukraine is at least 10 years late in terms of introduction of compulsory health insurance.". Ineffective protection of the Ukrainian population against health expenditure risks, and health finance inefficiency are core problems for health sector development. All respondents intimated that reform was long overdue. However, there remain strong institutional obstacles present in the system. Continued inaction could present the Ukranian health care industry with further problems in the future. Insurance Companies mentioned: Oranta Incorporated:

