The discussion of the draft strategy of the Ukrainian healthcare system reform started in Kyiv on Dec. 05, 2014.
The draft of the reform strategy has been developed by the Strategic Advisory Group (SAG) on the reform of the health care system in Ukraine under the Ministry of Health with the support of the International Renaissance Foundation.
The draft strategy is available at SAG website.
Dr. Eliot J. Pearlman and Yuliya Chorna both took part in the discussion and made presentations with constructive criticism and suggestions for improvement of the draft strategy.
Major recommendations of Dr. Pearlman's presentation "Constructive Suggestions for a Viable Ukrainian Health System" were:
- To develop National Center of Disease Control and Public Health managing strong Nationwide Health Promotion Program;
- To encourage robust sanitary-epidemiological service under auspices of the National Center of Disease Control and Public Health;
- To promote well-funded Clinical Preventive Medicine Services via community activities (Health Fairs) and school programs;
- To outsource procurement of Essential Medicines;
- To ensure strong emphasis on Primary Health Care.
Dr. Pearlman considers that the disease packages should be bundled together, e. g. TB and Diabetes.
In general, the approaches to healthcare should be governed by the main point of attack which is to decrease the high burden of diseases, especially non-communicable diseases.
In her presentation "Human Right for Healthcare under the Market Economy", Yuliya Chorna outlined the necessity to clearly define the notion of the “universal health coverage” which now is vague. Her point is that the universal health coverage should correspond with WHO recommendations and ensured for all citizens of Ukraine with the covered basic health service package. Different options of the funding mechanisms (single-payer, obligatory state insurance etc.) should be analyzed by the reform expert group and presented for public discussion.
Yuliya has also brought up an issue of the risks of abuses from the private insurance companies (denials on pre-existing conditions, catastrophic costs etc.) and suggested to tackle the risks by the provisions of the strategy.