Kolbasina L.P.,Faisal Hamid,Bobkova S.A.,Kushnir K.G.

The state institution “Crimea State Medical University named after S. I. Georgievsky”,Simferopol

The prospects of insurance medicine development in Ukraine.

Today the expenditures on medical services and drugs are comparable to amount of public financing of health care.But the decrease of medical care availability

leaded to the fact,that people go to the health facility more rarely.Ukraine has a high level of mortality in working age.Unfortunately this tendency not becoming better in despite of optimistical Ministry of Health reports.Nowadays the healthcare system not meet the full needs of modern society.Wasn't noted any cardinal changes in this field last decade.The health care's share of GDP has decreased sharply,the number of medical institutions also decreased,first of all in countryside,the different legal requisitions from patients became an everyday occurrence.The material resources of this field has declined because of chronic lack of funds and the moral foundations of medical profession was undermined.In a context where public funding does not exceed 40-50% of the needs, the only way to overcome the crisis is introduction of a medical insurance.In socio-economic conditions in Ukraine arrive at medical insurance is objective necessary.Insurance medicine – is the form of health organization, which provides mandatory public incuranse against deseases in combination with private medical practice and medical institutions.Such system of organization allows to make the salary of a medical staff and revenues of medical establidhments dependent on the quality of treatment and diagnosis.From a financial point of view the quality medical care receive is available to most citizens.The analysis of countries with transition economy,which introduced the mandatory insurance,showed, that Ukraine needs effective and simple model of mandatory health insurance.Ukranian insurers developed a version of mandatory health incurance system.As the pension system ,they want to make a three-level system.But the are great doubts, that the state dicides for this in the near time.The first level of incurance - government provision of citizen from government budget for medical emergency payment,disaster medicine,financing of national programs against AIDS and tuberculosis.The second level are out-patient and in-patient treatment,examination and operation conducting.Financing of this level is planned by employer or individual.Besides, the people who want

to receive the additional level of provision and service can enter into an insurance contract with chosen insurer,its the third level of insurance.The plus of this system,that mandatory insurance increases the quality of it.The realation between insured and insurance medical organization is implemented by insurance contributions.The insurance medicine is financed jointly:government, owners of the companies in 80 of medical services cost.It provides interest of all funding structures.

The ukranian society almost on the way to introduction of paid medicine with no any reforms and insurance. There are first experiences of medical insurance use.Analysis of current state of health insurance in Ukraine has showed ,the conception of development of voluntary health insurance system requires significant improvement. Is considered, the necessary also is in conducting of number of arrangements including adoption of regulatory legal acts, that could guarantee solution of such problems:

1.Providing of competitive environment in case of adoption of legislative act on mandatory social health insuranse.

2.Establishment of conditions for voluntary health insurance as an effective additional to mandatory social health insurance, existience of it could provide covering of costs of quality provision of medical care in amounts,which would determined in programs of mandatory social health insurance.

3. Legislative regulation of issues to improve concernment of employers relatively to preservation of health of their employees by means of the establishment of economic incentives,which will directed to voluntary health insurance,i.e. the entities can include in salary the payment of under contract of voluntary health insurance insurance payments,in this way the tax base decreases.

4.Improving the reliability of insurance organizations,which will work in voluntary and mandatory health insurance system by establish requirements for licensing according to clearly defined criteria;

5.Providing receipt of funds to the voluntary health insurance system through formation an optimal pricing system for medical services.

Clear and thought-out policy on the development of health insurance as part of the overall social and economic policy of Ukraine should determine the basic principles, directions and forms of economic, administrative and legal influence in the sphere of population social protection, taking into account national interests and priorities, including supporting of health insurance in the main areas, such as: regulatory base development , improving tax policy and state supervision, improving the financial strength of insurers, increasing insurance awareness of the population, training and retraining of employees.