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."