Healthcare reform in Ukraine now again is one of the key priorities for the political agenda. While the recently formed Strategic Advisory (Working) Group of experts under the Ministry of Health of Ukraine considers different options for the strategy of the healthcare reform, let us keep in mind that the values of Human Rights should govern the contextual framework of the strategy.
According to the Universal Declaration of Human Rights “the economic, social and cultural rights recognized in articles 22 to 27 include the right to social security”. Health is a necessary condition for human well-being; therefore, guaranteed universal access to the health services should be viewed as an integral part of any social security initiative.
Understanding the drawbacks of the current healthcare system, with its low quality of services, poor access to diagnostics, out-of-the pocket payments on the part of patients, it is still important to ensure that any reformed healthcare system will guarantee free access to basic medical services to every individual despite of his/her social group, income level, race, etc.
Striving for the business-friendly environment in the healthcare sector, one should understand the risks when health is viewed as a commodity and health services are based on profit-driven motives. In that case, the question is how to make all services affordable and avoid bankruptcy of individuals and families resulting from the high health-care costs- or the dilemma to go without in order to feed one’s family.
One of the approaches towards healthcare system reforms might be the implementation of a national health insurance model and although the funding mechanism in this model can vary, let us view particularly Canadian single-payer model. Canadian system is the approach where the government negotiates with the healthcare system and serves as a sole insurer.
According to this model both medical institutions and medical personnel keep their private status; however, the government through a tax collection guarantees universal coverage to everybody; that is healthcare in Canada is free. Canadian scheme consists of 10 provincial and three territorial insurance plans which cover diagnostic, treatment and preventive services to every individual. The Canada Health Act (CHA), which was introduced in 1984, is the major piece of federal legislation that governs health care delivery in all 10 of the Canadian provinces.
The overarching goal of the CHA is to ensure access to medically necessary services for all Canadians regardless of ability to pay. Under the CHA all provinces and territories must abide by five principles e universality, accessibility, comprehensiveness, portability and public administration in order to receive federal funding for health care. The principles are designed to ensure a publicly funded health care system in which all Canadians (universality) receive medically necessarily health care services (comprehensiveness), regardless of where they live in Canada (portability), which is free at the point of delivery (accessibility).
Despite the existing critics on Canadian single-payer system there are arguments in support of this model which might be taken into the consideration at the reforming of the Ukrainian healthcare system.