400 UAH per month from each

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The Rada has registered a bill on mandatory health insurance

Everyone should be insured. This is stated in bill No. 9163, which was recently registered by deputies – They propose to introduce mandatory health insurance. The employer will be obliged to pay for insurance, and if the person is unemployed, local authorities will pay for it. The size of the mandatory contribution will be determined by the Cabinet of Ministers, the project states. But the deputies believe that it should be at least 400 UAH. This is reported on the portal Segodnya.ua.

What the deputies propose

"Ukrainians finance the healthcare system at their own expense by 60%, and the state by 40%. As a result, medical care for Ukrainians has become catastrophically inaccessible economically and physically", – the deputies note in an explanatory note to the project. Therefore, the authors of the project propose to divide medical services into those that will be covered by the state and those that will be reimbursed by insurance.

What will the state budget pay for? The project lists the same list of medical services as in the current law. These are emergency medical care, primary care - treatment by a therapist, family doctor and pediatrician; specialized and highly specialized medical care; palliative medical care and rehabilitation; medical care for children under 16, pregnancy and childbirth.

A specific list of free services will be known only in 2019, when the Rada approves the new state budget. That is, Ukrainians will be informed every year that hospitals officially charge a fee and how much it will cost. The price of medical services will be the same in all medical institutions. What is not included in the state program, in fact, should be covered by health insurance.

The bill also states what insurance may cover. This includes diagnostics, treatment, prevention, rehabilitation, and medications. The list of services will depend on the contract with the insurance company.

The annual contribution for each person will cost approximately 4,783 hryvnias, or 398.56 hryvnias in monthly payments. Employers will have to pay it, and they will probably do so from salaries; local authorities will have to pay for the unemployed (from taxes received).

The bill sets a lot of restrictions for insurers. For example, an insurance company must keep money only in a state bank. The insurer must send 94% of the contribution to its reserve fund. It is from this that the company will pay for the treatment of clients. The insurance company leaves 5% of this amount for the organization of its work: this includes the company's expenses and profits. Another 1% will have to be transferred to the state Reserve Fund. This fund is supposed to become a "safety cushion": if an insurance company suddenly runs out of money, the treatment of patients will be financed from the Fund. The new structure will also control insurance companies.

It is total control that is alarming insurers. For example, the state Reserve Fund is a good way for officials to control cash flows for medicine. According to the authors of the bill themselves, thanks to insurance contributions, employers can "subsidize" medicine by 50-70 billion UAH.

The draft law No. 9163 was only recently submitted to parliament. It still needs to be discussed in parliamentary committees and receive an expert opinion, only then can it be put to a vote. Quite a lot of time may pass until that moment. For example, two almost identical projects have been in committees since 2016.

How health insurance works in Ukraine now

Voluntary health insurance (VHI) currently operates in Ukraine, but only 5-6% of Ukrainians have a VHI policy. Insurers offer VHI mainly to work teams - that is, an employer can arrange it for its employees. Currently, 90% of the entire personal insurance market is in the corporate segment.

After the start of the healthcare reform, some insurers began to offer individual VHI policies. The cost of individual VHI is 4-5 times more expensive than corporate VHI and can reach 20-30 thousand UAH.

In addition, individual insurance usually has more exceptions compared to corporate programs, insurance companies note.

Insurers are more focused on corporate VHI policies for a simple reason - employees never get sick. Insurance companies calculate their programs for this. And if everyone is allowed to be insured one by one, then only the sick will follow the policies, shares an agent of one of the insurance companies.

VHI will begin to develop when a database of all patients appears in Ukraine. Then the insurance company will understand what state of health a person comes to it with.

"When an all-Ukrainian database with confirmed diagnostic histories of people's illnesses appears – these policies will be individual, each will have its own conditions and prices, and then everyone will be accepted for insurance. While a certificate for any illness in Ukraine can be purchased for 200 UAH via the Internet, insurance companies will not deal with individual VHI", – an insurance agent told the "Segodnya" website.

How much does individual insurance cost:

• Up to 2000 UAH/year – most insurance companies are ready to make an appointment with a doctor for this money, provide a doctor's call to your home, and cover emergency care.
• From 3300 UAH/year – This includes a doctor's call to your home, a visit to doctors in state medical institutions, payment for medicines worth 800 UAH per year in case of illness, emergency care. If a person is hospitalized - you can receive up to 70 thousand UAH in compensation for medicines. For dentistry, 300 UAH per year is provided.
• From 7000 UAH/year - a doctor's call to your home, emergency room services, provision of medicines worth 1500 UAH per year, a visit to doctors in state and private medical institutions. For medicines during treatment in a hospital - up to 100 thousand UAH. For dentistry, 800 UAH is compensated.
• From 18 thousand UAH - the same as for the previous points, plus visits to branded private clinics, for dentistry - 2500 UAH per year, as well as compensation of 150 thousand UAH for medications in the hospital.

Not everyone can get insurance. The insurance company may refuse to sell a VHI policy to people with disabilities, those who are registered in dispensaries, have heart defects, hepatitis, tuberculosis, diabetes, suffer from epilepsy, cancer, mental or venereal diseases, or have ever used drugs.

Health insurance should be accessible, this is what the Ministry of Health emphasizes. But first, it is necessary to calculate the tariffs for each medical service, make municipal and state medical institutions competitive.

"In 2020, a state program of medical guarantees will appear in Ukraine, which will cover all levels of medical services, including inpatient ones. In parallel, from 2020, active development of health insurance should begin in Ukraine. The policy of the Ministry of Health of Ukraine is to provide every person in Ukraine with guaranteed coverage of basic medical services of primary, specialized, emergency care through the National Health Service. And additionally, to give employers, state institutions, local authorities and patients the opportunity to take advantage of the benefits of insurance,"" the Ministry of Health notes.