other priorities.
The first priority was the adoption of a law changing authority of the Cabinet of Ministers, and clarifying its relations with the president. The second one, not adopted, was efforts to change Ukraine’s Constitution in order to consolidate the president’s power. And the third priority has proven to be working to reformat the governing coalition.
The fifth and sixth largest priorities turned out to be early elections in Kyiv and efforts to hold a snap mayoral vote in Kharkiv. The seventh priorities seem to have been efforts to erect new statues and memorials throughout the world to Ukraine’s main poet, Taras Shevchenko.
As it turns out, reforming of Ukraine’s health care system was a low priority, about 50th on the list somewhere between the development of astrology and reconstruction of UFOology.
Ironically, the president himself knows just how dangerous Ukraine’s hospitals are, and how badly they are in need of reform. That is why he prefers to receive treatment for his 2004 dioxin poisoning Europe, at elite clinics located near the Alps. Expremier Viktor Yanukovych, along with most of Ukraine’s elite and lawmakers capable of jumpstarting health care reform, also seek treatment abroad.
“Tens of thousands of Ukrainians receive medical treatment abroad every month. I think in 5 to 7 years they will get the treatment here, in Ukraine,” Health Minister Vasyl Knyazevych said in June.
It would be a definite eyebrow raising event to run into Yanukovych in one of Ukraine’s hospitals, waiting in line for a physician. But it won’t happen, at least in the near future.
The dire state of Ukraine’s medicine was broadcast on national television for the entire nation to reexperience last winter. Yanukovych’s political ally, Yevhen Kushnyarov was transported to a regional hospital in Izyum, Kharkiv oblast, for treatment for a gunshot wound inflicted during an apparent hunting accident. Ethyl alcohol and bandages are not the best treatment for a gunshot wound. But that’s all he got for initial treatment, as there is often nothing more such regional hospitals can offer in aid.
Little has changed, however. Officials declared reform of the healthcare system to be a national priority but then ignored the issue leaving hospitals and clinics sinking deeper into ruins.
Article 49 of the Constitution guarantees the Ukrainian people free medicine. It is a good slogan, but does not correspond with reality. Due to miniscule statefunded salaries paid to doctors, most Ukrainians have to pay bribes for treatment at hospitals that are considered dangerous to their health. Ukraine is acknowledged by the world as a country with a market economy, but we still pretend to be North Korea. Medicine in Ukraine is paid for. It is expensive, inefficient and outright dangerous.
Sadly, it appears there will be no improvement either in seven or 77 years. Budget funding for the cashstrapped health care system increased from Hr. 5.4 billion to Hr. 31.2 billion during the last seven years. Do you feel the difference? Me neither.
The roots of the problems in Ukraine’s health care system are deep. For one, hospitals are financed not by the work load they handle, but by the quantity of beds they have.
Budget funding is allocated proportionally to hospitals to compensate for citizens registered in the area, not according to how many patients they treat. And finally, Ukrainian citizen can not choose the hospital they want to be treated at.
Public health has become an inefficient monopoly. It is not necessary to improve services, because patients will come in any case and will bring money. The noncompetitive environment made a real monster of Ukrainian medicine. The wards are awful. Hospitals have no diagnostic equipment or basic medicines.
It is obvious that it’s impossible to build an efficient public health system without investment. The question is who should invest and under what conditions.
Article 49 of the Constitution should be tossed into the history books, a copy preserved for Kyiv’s Museum of Medicine. Healthcare should be privatized; investors should be brought in to fuel competition, raise quality of service, and actually heal patients.
Hospitals can remain public property and get some state money, but they should at least be managed by private professional managers. Such a system, for example, exists in Britain. The expenses also can be covered by the insurance companies, as in the United States.
Everyone knows Ukraine’s health care system needs reforms, fast. Unfortunately, Ukraine’s political leaders and lawmakers are too busy speaking about national priorities to score political points, and then flying abroad for treatment, then to adopt such crucial reforms.
Oleksandr Paskhover is an editor at Korrespondent magazine.
