The Verkhovna Rada Resolution # 2426-IV as of February 4, 2005

About the Action Program of the Cabinet of Ministers of Ukraine
"Towards People"

(excerpt)

Health Care

Citizens' belief in future will be strengthening along with increasing their life expectancy and birth rate, and decreasing death rate. To provide quality and accessible health services, the Government will be providing:

• the guaranteed package of free health services for every citizen;
• introduction of the unified system of indices for health facilities' performance quality;
• renewal of healthcare system in every town and village;
• health financing re-focusing on the primary care;
• introduction of mandatory health insurance and promotion of supplementary voluntary health insurance;
• promotion to the establishment of the family medicine and family physicians;
• creation of the conditions for full vital activity of disabled people (invalids), the priority rehabilitation of the war veterans and labour veterans;
• free provision of medicine, drugs, special food to children-invalids, creation of the conditions to their full vital activity in the community;
• development and implementation of the effective mechanism for controlling the production, import and realisation of pharmaceuticals;
• introduction of telemedicine as means of accessibility to quality healthcare to the whole population, including rural areas;
• promotion of healthy lifestyle;
• a ten-time increase of the amount of financial aid when a child is born.

The full text of the Resolution can be accessed at
http://www.rada.gov.ua/ or in Room 113

Ludmila Podgornaya, Head of Division of Health Insurance Legal Provision

Why does Ukraine need a project like this?

Starting January, 2004, the EU/TACIS Project "Health Financing and Management in Ukraine" has begun its activity aiming at providing for financing and management efficiency improvement in the national health care system.

The TACIS program created in 1991 is the main instrument of cooperation between the EU and ex-soviet countries, mostly providing technical assistance.

The European Union is an inexhaustible source of working experience in socially oriented market economy. And it is from here where Ukraine can gain the required knowledge and assistance concerned with the issues of raising the operating efficiency in health care, as for a long time this particular sphere has remained apart from market reforms gaining their spin in other fields of Ukrainian economy.

What does MoH expect from the Project implementation, what is its specific character?

Ukraine has clearly defined its home and foreign policy towards European integration. It presupposes conducting economic reforms, bringing Ukrainian legislation in compliance with the European one, implementing the Agreement on partnership and cooperation with the EU.

Positive dynamics of basic macroeconomic indicators allows to predict that the economic growth in Ukraine is to acquire a stable and systemic character. These external factors are going to make a positive impact on the financial input into the health care sphere.

Nowadays we concentrate our attention specifically on the issues related to increasing the draft on funds efficiency, improvement of medical aid organization through developing, as a priority, primary medicosanitary aid and family doctor's institution, wide-scale implementing of ambulatory medical services as an alternative for in-patient treatment, regulating the health care establishments network and structure.

The urgency of the EU/TACIS Project is determined, first of all, by the necessity to prepare the sphere for mandatory health insurance implementation, which is stipulated by numerous Presidential Decrees and the Program of Governmental Activity, to work out the corresponding legislative acts as well as to train health care staff to work under new conditions.

European experts' assistance is going to allow us to take into consideration the experience of progressive countries and main approaches adopted in the European region countries.

Within the framework of the project there have been chosen two Pilot regions (Kharkiv and Zhytomir oblasts), on whose basis new financial management models are to be developed and tested.

In what way can other countries' progressive experience be applied in Ukraine?

The practical work of the Project is to be focused on the four main directions, in particular:
health care management optimization under conditions of medical insurance system implementation in Ukraine. This direction is to cover both, the highest administrative level structures of the field and internal local level managerial structures of health care establishments;development and implementation, on the basis of the Pilot regions, of all components required for health insurance system implementation in Ukraine; development and implementation of comprehensive training processes for specialists at different administrative levels, heads of health care establishments and the future health insurance system experts in the field of health financing and management; conducting campaigns aimed at increasing the level of public awareness of health care organization issues.

Besides that, a joint work of the Project, MoH and other interested parties is to be conducted on the issues of developing the legislative framework for mandatory state social health insurance taking into account the European legislation, developing and testing the health insurance program, procedures of contracting medical services providers.

A special place in the Project work is devoted to the issues related to the improvement of informational and technical support in health care establishments.

The work is to partially be conducted at the national level, while its other part is to be realized on the Pilot regions basis.