On Tuesday, June
2, Prime Minister of Ukraine Arseniy Yatsenyuk took part in a meeting of the
Board of the Health Ministry of Ukraine, during which it was discussed the
legislative initiatives of the Ministry of Health aimed at reforming the
healthcare industry.
Following the
speeches of Minister of Health Olexandr Kvitashvili, chairwoman of the
Parliamentary Committee on Health Olha Bogomolets, representatives of the
Health Ministry, Arseniy Yatsenyuk stressed the need to "identify the key issues
that the country as a whole and Ukrainians are facing now": "Now
these are the issues of national security: low duration and quality of life. These are the two major challenges
that must be resolved."
He stressed that
today Ukraine possesses "the old post-Soviet system of medicine":
"While the old system is still functioning and a new one has not been
built yet, we are between two chairs."
He recalled that
around 4% of GDP from the State budget had been allocated for health care. Most of these funds are used to pay
for utilities and medical institutions, pay salaries to health care employees:
"All the rest – on residual principle, including costs for medicines and
new technologies."
"Now the
whole system of health care financing is actually reduced to only one thing: it
is functioning on artificial respiration and sometimes, when vital organs stop
working fully, we use a defibrillator," the Prime Minister said.
Arseniy Yatsenyuk
emphasized that this situation has to be changed, primarily by honestly
answering the question whether there is a free medicine in Ukraine: "It
exists only on paper. If
we keep on telling a lie to themselves and, most importantly, to the people of
Ukraine, we will not forward matter by a single step. Even
communists had been unable to provide absolutely free medicine. We
must admit it and find a formula and shape of the health system, which we offer
to the country."
First, according
to him, ambulance services should be provided free: "Everything that
corresponds to ambulance services should be one hundred per cent funded by the
state."
He appealed to
the Health Ministry to provide specific calculations, "including emergency
aid calls ": "It often happens that one patient needs to call an
ambulance many times instead of receiving the appropriate level of healthcare,
for which ambulance services are responsible."
In addition, the
state should also provide primary care: "Without high-quality primary care
and preventive treatment, then-patient care is ten times more expensive for us,
and sometimes it’s too late to help a man."
In Arseniy
Yatsenyuk’s opinion, we should "move to the state health insurance":
"A lot of people – after difficult challenges, after the waged war, after
the economic crisis since 2008 and just strengthening of Russian military
aggression - cannot afford to pay for health services. We should move towards the state
health insurance. We
have no other option – it is the joint responsibility of the society. We
are not the only ones who live in such a way, so lives Europe, so live the
United States."
He
recalled that President Barack Obama during the last two terms in office
"has being promoted the so-called ObamaCare" (medical insurance
reform - ed.). Before the introduction of this
reform, the Prime Minister stressed, 30 million of Americans had no opportunity
to even call an ambulance, because it was not covered by insurance: "We
have 99% of Ukrainian that are not covered by insurance. I
hope that we will have Kvitashvili-care."
Thanks to
the introduction of public health insurance, he emphasized, "the one, who
paid money, will know that the operation for hundreds of thousands of hryvnias
will be paid from the state health insurance fund."
In addition,
Arseniy Yatsenyuk considers it necessary to bring order to the medicines
supply, because the health care system "is now based on the principle of
drug advertising, but not the principle of feasibility of drugs and medicines
for the patient."
In the framework
of the transition to the state health insurance, the PM called binding the
implementation of medical protocols, "A medical protocol should provide a
formula of how and what you treat and I am, as Prime Minister, interested in
two things: the effectiveness of this treatment and its price. There should be a single standard."
He urged
representatives of the health care system, "You’ve done your job, billed
the budget - and we cleared that bill, but we paid the bill for a healthy
person, not the number of days in bed, for quality care, not for the
discarded drugs."
Such changes,
Arseniy Yatsenyuk highlighted, need from medical employees "primarily to
change their mindset": "The reforms do not occur in the office of the
President or Prime Minister. There they can be launched, but they
should be implemented from below. And
any good idea can be just destroyed by irresponsible performance on the
initiative of the masses. The
person communicates directly with the doctor or pharmacist in the district,
village and town and through relationship towards he/she the person perceives
whether something has changed in the country or nothing has changed except the
names and faces."
"I
want and I demand that all change in the country, including the health system. There has been the same conversation
for 23 years: over the state guaranteed minimum of medical services, over the
fact that we must move away from "the Soviet Union bunk-bed" to the
particular patient, over the autonomy for medical institutions, over the
introduction of protocols. We
don’t have 23 years more," the Prime Minister said.
Arseniy Yatsenyuk
appealed to Health Minister Olexandr Kvitashvili: "We have three months. We have the Parliament that wants changes. We have the
Ministry that proposes changes. In
September I demand results both in the adoption of bills and the purchase of
drugs and medicines, as well as providing vaccines. A concrete result."
The Prime
Minister noted that by September he would "check" all the ministries,
"Some members of the coalition simply forgot what the coalition Government
means. Political responsibility,
responsibility to the state and people of Ukraine for the reforms to be carried
out, lies with the coalition, Government, Prime Minister and President. And we should bear this
responsibility. And
we should report to the Ukrainian people what was done, what we managed, what
failed, how we are going to improve it," he said.
"If
people are not having a feeling of real changes, then the whole political top
of Ukraine will be changed", the Prime Minister underlined.
Arseniy Yatsenyuk
also noted that he welcomes debate over medicine reform: "This is our sign
of democracy. The chairman of the Committee from
Petro Poroshenko Bloc criticizes the Minister from Petro Poroshenko Bloc. This is normal. The coalition criticizes
the PM- this is also normal. But
I would really like this political criticism to have a professional focus. We are not in elections. We
have been already chosen, now it's time to take responsibility to the country
for what we promised."