Criteria and parameters of efficient model of health service financing support in Ukraine

Abstract

Increasingly important role of health as a socio-economic category necessitates the introduction of proven approaches and strategies in determining the state social policy, the success of which today depends on the extent of its impact on health. Though, as worldwide experience shows, formation of modern economic models of effective health care systems is featured with national characteristics, it follows certain universal criteria. Achieving the goal of formation of modern socially responsible health care systems is based on the approach that should provide: a) universal coverage of medical care, and b) consolidation and reallocation of resources, risk equalization. At the same time realizing the potential of health systems requires, above all, good management and adequate resources costs. An objective increase in health care costs and limited resources in the industry encourage a search for instruments of financing policy aimed at rationalizing expenditures. The distribution of funds based on political negotiations, accompanying the budget process, precedents of previous years, providers’ proposals or, finally, based only on the number of population has not turned out to be cost-effective, as the European experience confirms. Moreover, such a distribution complicates the possibility of collective payer to influence the medical care process. All this apparently calls for a shift from passive reimbursement of providers’ costs to active procurement of services. Meanwhile, the potential impact on the soundness of Ukrainian public health care system remains limited. The article examines the key challenges and shortcomings of health financing policy in Ukraine. It has been proved that the current funding model does not allow the health system to fulfill its functions. The author has determined specific parameters of the optimal model of multi-channel health financing system and proved the introduction of social health insurance to be an effective tool for pooling and redistribution of financial resources, a backbone mechanism, and economic catalyst for reform in the industry.