On Tuesday, September 5th, Ukraine’s Parliament returns for its fall plenary session with passage of key reforms on the top of the agenda. Parliament failed to bring sweeping healthcare reform legislation for a vote in the second reading prior to adjourning for summer vacations in July. Other votes on important education, economics and pension reforms also await passage by Parliament this autumn.

Speaking on Wednesday, Prime Minister Volodymyr Groisman said, “The next session of the Parliament begins next week. Today, many people are worried about this political autumn. I understand that there will be many attempts to ruin the situation again. But I think that today it is very important to keep the first signs of stability that we have and take steps to further changes that people expect…in healthcare…and in other important areas. So I would like this autumn to be the first to be effective. Today I appeal to deputies of the Parliament, to politicians - we must reject ambitions and contradictions, we must make important decisions to make change in the country irreversible. Now in the Parliament there are a number of important bills ready to for consideration, and if we unite our efforts…then we will be able to enter the next year with a solid foundation for Ukraine’s future success.”

Support and momentum for passage of healthcare reform has been steadily increasing since February according to sociological data from the respected research firm, Rating Group. From the data, it is clear that the more the public knows about the reforms, the more likely they are to support them. The most recent survey completed in early August shows that 72% of Ukrainians support the package of reforms encompassed in draft law #6327, with just 15% opposing them. In addition, each of the ten key elements have positive and/or majority support (see table below).

Initiative Nationwide Have Heard Have NOT Heard
State Insurance 69-19% 76% 58%
Free Medicines 91-6% 93% 83%
Hospital Districts 45-41% 47% 43%
30% Salary Increase 67-22% 80% 51%
Patient-Doctor Contacts 58-26% 74% 46%
Prevention Centers 77-14% 89% 69%
Reference Pricing 77-9% 90% 67%
Standard Protocols 67-11% 85% 59%
IDP Subsidies 72-19% 88% 62%
Okhmatdit cost controls 89-5% 96% 82%

In addition to strong public support, healthcare reform has also been endorsed by President Poroshenko, Prime Minster Volodymyr Groisman, the National Council on Reforms, G7 country ambassadors, numerous patient organizations, church and religious leaders, anti-corruption organizations, and many others. Ironically, the only segment of society that has not yet embraced the reforms fully is the Parliament of Ukraine. The same poll by Rating Group notes that when Ukrainians seek medical advice, a supermajority (more than 60% each) trusts their families, friends, and medical professionals for such advice. People’s Deputies of Ukraine s scored the lowest with just 4% of Ukrainians trusting them for medical advice. As a point of reference, parliamentarians scored even worse than witches (so called “extra-senses”) which were trusted by 17% of the population.

Procedurally, the Parliament needs 226 votes in favor of the healthcare reform on two separate occasions. The first vote passed with 227 votes in early June. As further evidence of the growing support for the reform - even among parliamentarians - the opposition party “Nash Krai” (Our Country) recently demanded that 300 votes are needed for passage, claiming that healthcare reform is a “constitutional” issue. Such statements and the circus-like antics of some people’s deputies during the last day of the July plenary session of Parliament, are designed to delay the passage of the legislation indefinitely against a sea of strong public support. Next week Parliament will set the agenda for voting and the second reading of healthcare reform is generally expected in September.

The new model proposed by the Ministry of Health creates a safe, stable and guaranteed system which raises Ukraine’s healthcare level to international standards. This system is based on three fundamental principles.

  • First, state budget money will now “follow the patient,” and pay for medical services, rather than be disbursed based on an obsolete formula that only support only system infrastructure.
  • Second, a unified set of medical services that are financially covered, will be defined and established for all citizens.
  • Third, international best practices for treatment and diagnostics will be introduced to ensure that citizens have control over the quality of services provided.  

These principles will be implemented through the passage of the healthcare reform package proposed by the Ministry of Health.

The key provisions of the legislation include:

  • Institution of state funded medical insurance for all Ukrainians with financial guarantees of coverage for a wide range of medical services. This provides a safety net to protect all citizens so that no one is left alone with medical access and treatment.
  • Free medicines for patients suffering from chronic diseases such as asthma, type II diabetes, and cardiovascular diseases. State medical insurance will then reimburse the pharmacies.
  • Introduction of “Patient and Family-Doctors Contracts”. These contracts will ensure mutual responsibilities at locked in annual prices. This way families can live within their budget while receiving trusted medical attention from their family doctor. Moreover, people will finally begin to visit their doctors.
  • Increase of salaries for family doctors by 30% with the opportunity for good doctors to earn even more money. With average doctor’s salaries at a mere $200 per month, it is critically important to reward the best doctors to avoid brain drain to other countries.
  • Creation of regional health centers focusing on disease prevention, as well as preventing epidemics. Currently, 99 cents of every dollar in Ukraine is spent on treatment instead of prevention. As a result, Ukrainians die an average of ten years earlier than their European neighbors. Promotion of healthy lifestyles will prolong the quality of life of Ukrainians as well as the life expectancy. 
  • Establishment of reference pricing for pharmaceuticals to protect patients from corruption and price gouging.
  • Introduction of evidence-based, internationally recognized medical protocols for standardized treatment procedures of all disease.  It should be noted that in healthcare reform working group removed this provision from the amended version of draft law #6327.  However, the most recent survey by Rating Group shows that Ukrainians trust international medical protocols over Ukrainian protocols by a 58-20% margin.
  • Institution of strict costs controls and transparent financing for the construction of the modern diagnosis medical complex “Okhmatdyt”.
  • Provision of medical subsidies to internally displaced persons (IDPs) from the Donbas and Crimea, which now number more than 1.8 million persons.
  • Creation of hospital districts to provide local access so that no citizen is more than one hour from a modern medical facility.

Passage of healthcare reform is critically needed by Ukrainians to replace the broken Soviet system.  Your continued support is important to ensure that the Parliament does not delay any longer to pass the needed reform.  You can make a difference by:

  1. Follow us on Facebook: like our posts and join the conversation to support healthcare reform.
  2. Forward this newsletter to your friends and family so that they can subscribe to our mailing list for the latest information on healthcare reform in Ukraine
  3. Follow the Minister of Health on Twitter: like our posts and retweet them. Join the discussion.
  4. Check our website often for updates at www.moz.gov.ua

Together we ARE bringing an international standard of healthcare to Ukraine!

From Your New Team at the MOH!