The Council adopted madrepora. Major changes

Рада приняла медреформу. Главные изменения

The essence of the medical reform in Ukraine to 2017

What will change for the Ukrainians after the launch of health reform.

The Verkhovna Rada voted for the bill, necessary for the introduction of medical reform.

The draft law “On state financial guarantees for providing medical services and of medicines” No. 6327 (author Suprun) overall 240 deputies voted.

The main thing that will bring reform is the separation of medical services into two types: free and paid. The first version of the bill includes the third – the co-payment.

In the first reading the bill was adopted on 8 June. The second reading of the draft significantly altered.

Two other bills, one of which makes changes to the Budget code (No. 6604, author of the Cabinet), and the second concerns improving the accessibility and quality of health care in rural areas (No. 7117, author of the President), was adopted in the first reading.

As stated by the acting head of the Ministry of health Ulyana Suprun, changes made from the draft “imitation reforms.”

Корреспондент.net figured out how to change medifarma medical service of the Ukrainians.


The essence of the medical reform

The main provisions of health reform:

– the division into free and paid services;

– payment for services and contractual relationships with medical institutions;

– introduced the concept of guaranteed package is a clear scope of obligations of the state regarding medical services and medicines;

– independent providers (hospitals, local authorities, Ministry of health) customer medical services – the national health service of Ukraine;

– the lack of reference to the place of registration;

– e-Health, which will determine how many and which hospital the government should pay for the services rendered to the patient.

Рада приняла медреформу. Главные изменения

That changes medifarma in Ukraine

Medifarma will be implemented gradually. At the first stage – from 1 January 2018 the reform will apply only to primary medical care. That is, for the provision of medical services by family doctors, the patients will have to sign with them the Declaration.

In 2018-2019 gradually megaranto program will be implemented at secondary and tertiary levels. First, the program will be tested on pilot projects in selected health facilities, towns or regions.

Completely reform at all levels of the provision of medical services will work only in 2020. Prior to that medical institution which will not pass to new principles of financing, you will be able to receive subsidy for their activities from state and local budgets.

Who, what and how much to pay

The reform involves several key changes that will be felt by Ukrainians in the 2018-2019 year. In particular, every year in Ukraine will be “the program of state guarantees of medical care of the population” (programme of megaranto).

In fact, the state generates a list of free medical services paid from the state budget. Also, the list will include medicines that are provided free to patients in medical facilities.

Medifarma suggests that now in Ukraine there will be two main principles of payment of medical services or patient at the expense of own funds, or government from the state budget.

The bill says that the government will be paid for medical services, products and medicines for prevention, diagnosis, treatment and rehabilitation in connection with diseases, injuries, poisoning and pathological conditions, as well as in connection with pregnancy and childbirth.

Program megaranto will annually be approved together with the budget for next year. In the enacted bill, with the exception of medical care at the primary level and during epidemics, does not specify which services and drugs will be free.

However, it says that on them every year Ukraine will spend from the state budget the amount of not less than five percent of GDP. In addition, the free will remain emergency and palliative medical care.

State and municipal medical institutions will be provided and paid services, but in the amount of not more than 20 percent of all services provided and only to the end of 2024.

To receive free services from the program megaranto patients will need to sign either a family doctor or internist or pediatrician “a Declaration of choice of doctor”.

In fact, this will be a contract for the provision of medical services. When choosing a doctor will not be in a place of registration of the patient. In addition, the doctor will not be allowed to refuse a Declaration because of the presence in a patient of any chronic disease, age, sex, social status or financial status.

Only the doctor has the right to issue a patient referral for the provision of services at secondary or tertiary level, free of charge, if these services are included in the program of madhurani.

Media published sample prices fully-paid medical services:

In addition, the patient should undergo preventive medical examinations in the manner prescribed by the Ministry of health, to carry out doctor’s instructions and to comply with the internal regulations of medical institutions.


Changes for doctors

The bill provides that the salary of doctors is at least 250 percent of the average wage in Ukraine in July last year.

This year the average salary was 7 360 UAH, doctors ‘ salaries next year could reach 18 400 hryvnia.

Also introduces the principle “money for the patient.” For each patient the doctor will pay on average 370 per year.

Рада приняла медреформу. Главные изменения

In the ambulance will have doctors / Getty

In the ambulance there are the paramedics. From the current ambulance they are characterized by a “reduced” level of training.

Earlier Suprun explained that at first the paramedics will retrain paramedics who work in emergency teams. “This is a program with duration of one month,” said Suprun. In the future, paramedics will train from scratch in three years.


Medicine in the village

A separate document Parliament voted for a presidential initiative to improve the quality of medical services in rural areas.

According to her, the Cabinet of Ministers is now obliged to provide in the state budget funds for rural health facilities with equipment and transport for maintenance of the rural population.

Among other things, will be procured modern computers and telecommunication technology to physicians without having to travel to the villages, could provide online consultation to patients.

In addition, it is planned to purchased a portable diagnostic tool for gathering and transmitting information about the condition of the patient, mini-lab for tests, etc.

Рада приняла медреформу. Главные изменения

Medifarma in Ukraine / Getty

Also provides for purchase of air, water, road special sanitary vehicles, including those equipped with resuscitation tools.

The law on the improvement of medical care in the village shall enter into force the day after publication.