Association of Private Medical Institutions of Ukraine together with American Chamber of Commerce held a round table “Private medicine in healthcare reform and post-war reconstruction of Ukraine”
April 25, 2023 The Association of Private Medical Institutions of Ukraine, together with the American Chamber of Commerce in Ukraine, held a round table “Private medicine in healthcare reform and post-war reconstruction of Ukraine”.
The round table was attended by representatives of the largest private medical institutions of Ukraine, including the General Director of the St. Paraskeva Medical Center Tatyana Mikhnova, General Director of Dobrobut Medical Network Vadim Shekman, General Director of Medical House “ODREX” Tigran Arutyunyan, General Director of the Medical Center “Stork” Valeriy Zukin, Director of the CSD Medical Laboratory Oleksandr Dudin, General Director of the Medical Laboratory “DILA” Oleksiy Babych, Olena Yeshchenko, Chairman of the Association of Private Medical Institutions of Ukraine and General Director of the Medical Center “Smart Medical Center”.
The event was attended by representatives of the World Health Organization, USAID, as well as independent think tanks — Kyiv School of Economics, Ukrainian Center for Economic and Policy Studies named after Alexander Razumkov from international humanitarian and donor organizations.
Key issues for discussion were the following urgent challenges:
- Use of the potential of private medicine in wartime and for the post-war recovery of the health system;
- Logic of medical reform, taking into account the peculiarities of wartime;
- Ways to expand Ukrainians' access to quality medical services, including co-payment models and voluntary health insurance.
The event was attended by the Minister of Health of UkraineViktor Liashko, Chairman of the Committee of the Verkhovna Rada of Ukraine on the Health of the Nation, Medical Care and Health Insurance Mykhailo Radutskyi, Anna Purtova, Chairman of the Subcommittee on State Investment Projects of the Budget Committee of the Verkhovna Rada of Ukraine, Tetiana Donchenko, Deputy Head of the Social and Humanitarian Security Service — Head of the Department of Humanitarian Security and Human Development of the National Security and Human Development Apparatus of the National Security and Defense Council of Ukraine, as well as representatives of think tanks and private medical institutions that are part of the Association of Private Medical Institutions of Ukraine.
During the round table, representatives of the government and the Verkhovna Rada talked about reforming the health sector to solve pressing issues regarding its recovery and development. For their part, the representatives of the sector of private medical institutions during the meeting with the representatives of the state expressed readiness to cooperate and proposed to implement modern mechanisms for financing the health care system. They will help attract investment in the industry, create market competition between institutions of different forms of ownership to improve the quality of medical care for the general population. And at the same time, transparent financial mechanisms will help reduce the circulation of shadow funds and informal payments in the system of state medicine, which make it difficult for people to access quality medical services.
Minister of Health of Ukraine Viktor Liashkoproposed to hold such dialogues on a monthly basis so that representatives of the health sector, the state and legislators develop an effective model for the development and recovery of Ukrainian medicine as soon as possible.
“Looking to the future, we see our cooperation to realize three key priorities: ensuring the availability of health care, its quality, and the patient's free access. The state should make a targeted investment of a limited resource for the development of a network of world-class healthcare institutions. That is why the issue of private investment, not just donor funds or budget funds, is on the agenda of post-war recovery. We are interested in bringing private investment into the Ukrainian healthcare system for the emergence of new technologies and improving the accessibility of medical care. We turned to think tanks, economists with a request to carry out independent modeling on private investment in the health care system. So that after a certain time we will meet and hold the next discussion — so that we can all together know the right decision. We need to meet monthly, because the issue of reconstruction is relevant now. Public and private medicine must develop together, carry out a system reboot without wasting time. The Ministry is open to cooperation, we have to talk about the creation of a rational mechanism of co-payment, its launch” Viktor Lyashko, Minister of Health of Ukraine, said during the event.
Among the effective tools, the Minister mentioned the introduction of public-private partnership, the possibility of introducing a co-payment system, the development of a system of voluntary health insurance in combination with state medical guarantees. As a good example of cooperation within the framework of public-private partnership, the Minister cited the creation of a system of voluntary pharmaceutical insurance: the system was created “from scratch” in a dialogue between the state, the private sector and professional associations. The system has not yet become widespread, but the first steps of its activity indicate the prospects and mechanisms for its development. The Minister stressed that co-financing and insurance in combination with the system of state medical guarantees serve to reduce the financial burden on people.
Mykhailo Radutskyi, Chairman of the Verkhovna Rada of Ukraine Committee on National Health, Medical Care and Health Insurance, stressed the importance of creating a system of effective public-private partnership. Speaking at the event, he spoke about the directions of health law reform, which are being worked on by the relevant committees of the Parliament, the Ministry of Health and the Government, the National Security and Defense Council, and the projects are being examined for compliance with the legislation of the European Union. By declaring the purpose of joining the EU, Ukraine must comply with its legislative standards.
“Do I need a co-payment? Yes, needed. First of all, Ukraine should create equal conditions of competition for private medical institutions, public and municipal. In particular, this is the issue of compensation of utility tariffs, distribution of local budget revenues from personal income tax, redistribution of NHSU funds. Ukraine should develop a single standard of quality of medical services for the public and private sectors — this is a task for doctors, the state and patient organizations. If the issue of co-payment is settled by developing voluntary health insurance, it is necessary to change the tax system so that employers can attribute these costs to expenses. The development of voluntary health insurance will also require the establishment of clear standards for the quality of health services covered by the insurance. — said Mykhailo Radutsky, Chairman of the Verkhovna Rada of Ukraine Committee on National Health. — Amendments are now being prepared to the Law “On Public-Private Partnership”, to which we will make proposals agreed with stakeholders for the development of public-private partnership in the field of health care, including the issue of private investment for the restoration of war-damaged medical infrastructure. There is a common vision of the deputies and the ministry on the need to develop competition between medical institutions of all forms of ownership — only it will become a qualitative driver of the development of the healthcare system.
Olga Gavrylyshyn, Strategic Development Manager (Healthcare) of the American Chamber of Commerce in UkraineDuring the event, she stated that foreign businesses are ready to invest in the development and post-war reconstruction of Ukraine, including the health sector, and therefore its representatives are ready to contribute to the further implementation of medical reform and new modern instruments of financing the industry.
“According to a survey by the American Chamber of Commerce in Ukraine and USAID, 64% of the chamber's member companies plan to continue operations in Ukraine after the war. Moreover, 36% plan to continue operations with increased investment. This survey demonstrates the focus of companies on the restoration and expansion of existing business in Ukraine, on their active participation in the reconstruction and economic recovery of the country. We see Ukraine's openness to partnership. The Committee of Healthcare Providers operates within the Chamber, and its main priority is the widespread introduction of voluntary health insurance in Ukraine. Such a policy will stimulate people to invest in Ukraine, it is one of the 10 priorities of the country's post-war economic recovery. In order to realize these priorities, we continue to cooperate with our partners. Including with the American International Development Financing Corporation, which also collaborates with the private sector, to solve large problems of the infrastructural nature of developing countries. They invest in many sectors, including healthcare, we have successful examples of cooperation”. — said Olga Gavrylyshyn, Strategic Development Manager (Health) of the American Chamber of Commerce in Ukraine during the event.
Olena Yeshchenko, Head of the Association of Private Medical Institutions of Ukraine, emphasized in her speech that private medical institutions have proven to be a reliable partner, helping people from the first days of the military invasion, making efforts to preserve medical infrastructure, save jobs, and with this widely help people — victims of war, internally displaced individuals supported humanitarian initiatives.
“On behalf of the Association of Private Medical Institutions of Ukraine, I would like to emphasize that we support the reform of the healthcare system, namely: we support the provision of high quality medical care for Ukrainians, the introduction of advanced world protocols and standards of treatment, telemedicine and other technological innovations; we support the electronic health system — without unnecessary bureaucracy Procedures. It is extremely important for us to be included in the infrastructure of the health system, in a capable network that is currently being formed. We also advocate that each of the Ukrainians have a choice — where to receive medical care, we emphasize the need to comply with the approach “money goes to the patient” declared in the program of medical guarantees. We are impressed by the priority declared by the state on financing the medical industry. And now our common strategic task is to develop practical mechanisms of interaction and involvement in healthcare reform of private medical institutions, to take into account their role as equal participants in the post-war reconstruction of Ukraine. Today, we — representatives of the private medicine sector — are doing everything possible to win Ukraine, support the economy, provide quality medical care. We are ready to be involved in all important processes to modernize the industry as a socially responsible business”— emphasized Elena Yeshchenko.
As a result of the discussion during the round table, its participants adopted a resolution on the prospects for the participation of the private medicine sector in the reconstruction of the Ukrainian economy, taking into account the achievements and negative aspects of the four-year experience of health care reform. In particular, the resolution emphasizes that the vector of the main efforts to reform the sector should be adjusted to take into account the unprecedentedly complex challenges of wartime. To develop additional effective mechanisms of reform, their practical implementation and control of application, it is proposed to create a special working group at the Ministry of Health of Ukraine, which will include representatives of relevant bodies of state power, business, international organizations and public associations.
Another practical result of the round table with the participation of representatives of the state and the private health sector was the agreement on the preparation and implementation of a pilot project to develop new mechanisms of financing, public-private partnership and investment for the health sector.