In Zhytomyr region the MINISTRY of health debunks 10 common myths about health reform
in Recent times is spreading a lot of myths and horror stories about medical reform in Ukraine. The MINISTRY of health has collected 10 of the most popular and wrote the truth about the changes that will happen with the Ukrainian health system, once the Parliament decides on governmental bills. Myth 1. Medical care will be paid and very expensive Free medicine in our country does not exist. 90% of medicines purchased for the personal funds of citizens. According to studies, every second patient is refusing treatment or delaying it because of lack of money. So, to say that medical care will BE paid and a very expensive wrong. It is now expensive. The reform introduces new strict rules in the medical system, it is the same for every citizen. For each medical services is clear — it is government paid, or not paid it fully or partially? There will be a clear list of the services that will be fully 100% funded by the state. So, always free to the patient would be primary care services, family physicians, internists, pediatricians. Free will also emergency assistance — if you get to the hospital as a result of a sharp deterioration in health (heart attack, stroke, acute appendicitis, etc.), after an accident or personal injury. Gratuitous on the part of the patient and palliative care rendered to terminally ill (especially adequate analgesia). Always will be 100% paid for management of pregnancy, childbirth and the treatment of children. This is required by the international Convention on the rights of the child and on maternity protection, ratified by Ukraine. Treatment with respect to services secondary (specialized) and tertiary (highly specialized) levels also will be paid by the state, but some of them may be a slight SPOPAT of the patient. It will be much less than what we pay now. Are clear precise mechanisms how it can be covered for those people for whom even small funds is a problem. Such mechanisms are separate programs, for example, medical subsidies, programs for the treatment of certain diseases. For expensive treatment, as will exist in the target program, not going anywhere a program for the treatment of cancer, hepatitis, AIDS, etc. Myth 2. Medifarma will lead to the closure of hospitals and dismissal of physicians The bills on madrepora there is no word about the closure of medical institutions or reducing staff. In the first stage of the reform treaties of the National health service will be signed with ALL hospitals, so no one is left without medical assistance. But over time, competition and the principle "money follow the patient" will lead to the streamlining of the network of health facilities is weak, poorly equipped and most importantly — the busiest hospitals, which is simply dangerous to be treated, will develop into the real needs of the population, for example, rehabilitation, diagnostic centers, hospices that will receive funds for specific services. The best hospitals will be further strengthened technically and human to everyone who accesses them, had the opportunity to receive quality medical care. With regard to the possible dismissal of the doctors, then no work can remain only those who do not want to go people. A good doctor will always have patients flow and decent money for their work! Reform will encourage doctors to compete for patients. It is worth emphasizing that streamlining the network of medical institutions will be engaged in local government. Communities must decide which of them need to strengthen and which to restructure the state puts only technical requirements regarding travel to the hospital and its minimum load (the number of births, surgical interventions). With decentralization, local budgets have sufficient funds in order to improve the network of medical institutions, to create adequate working conditions for doctors, to repair roads, to hospitals, to pay for additional medical services for the residents of the community. The government, for its part highlights the targeted investment subsidy for the strengthening of the support institutions and the redevelopment of the weak and malonarushennye. Myth 3. Villages will be left without doctors In the villages that people are most concerned about the fate of paramedics and first-aid stations. FAPs will not go away. Paramedics will not replace the work of the doctor, but will become its satellites, and helpers in order to access medical care was in the most remote villages. In 2018, the year, the average payment for primary care will be about 370 UAH per patient, in 2019 — 450 UAH. For 2000 patients it will generate annual income of 740 000 in 2018 and 900 000 UAH in 2019, this budget includes rent, doctors, paramedics and nurses, simple supplies, and partial coverage. Medications in this budget are not included. So far the village has never had such funds in medicine and we are pleased that the reform finally allows to expand direct financing. Local governments will be their ability to improve the quality of life of a physician. For example, if the community will build a quality clinic and housing for the doctor, which will rent for 1 UAH will be much easier to find and invite the doctor to work. The amount of funding that would be allocated from the state budget for the medical care of one patient, the same throughout the country. However, life in the countryside is cheaper than in the city, and therefore if services are provided the same number of patients, the doctor will have a better financial position than the city. In addition, unlike doctor in the city, rural in fact will not have competitors. To elect him will be the whole community and the Declaration of the doctor will conclude all the villagers — and the doctor will get money for their medical care. However, this does not mean that the villages will be able to work non-professional doctors and residents have no alternatives – the community may withdraw from a bad doctor and to invite another. Myth 4. Have to pay twice: once officially in the cashier and bribe the doctor Since it will be determined the tariff for the service which is to be known, then reason to give bribes disappear. The state directly pays all the costs to provide specific services. Every year the government formally to inform citizens about the number and cost of services it will cover 100%, but partially. All SPOPAT to be official, transparent and open. The doctor refuses to help or medicines within the guaranteed package of medical services, or any demands from the medical staff to pay an additional informal means – a crime for which provides for liability, including criminal. In the case of misconduct of a doctor, the patient will be able to complain to the National health service, which will carry out control over observance by doctors and medical institutions conditions of contracts on service of the population. NCSU has the right to terminate the contract with the doctor or health facility for the care of patients in case of violation of the terms of the contract. Myth 5. The doctor can only be accessed through a family doctor Not true. Every person, if necessary, will be able to access any specialist without a referral of a family doctor and get help. But in this case the patient will have to pay the full cost of medical services and treatment. If you go to his family doctor, the cost of your treatment and the necessary medical AIDS fully or with a small SPOPAT will reimburse the state. Myth 6. Reform unconstitutional Thanks edreform the state will finally begin to comply with article 49 of the Constitution of Ukraine. This issue was resolved by the distinction between medical aid and medical service. After all, component of the medical aid tariff for the service will always be paid for by the state, as required by the Constitution. This was confirmed by the Ministry of justice of Ukraine, which notes: The draft Law "On state financial guarantees for providing medical services and of medicines" developed in accordance with article 49 of the Constitution of Ukraine in system communication with article. 95 Of The Constitution Of Ukraine. In article 49 of the Constitution stipulates that the state creates conditions for effective and accessible for all citizens medical service. In state and communal health institutions medical care is provided free of charge. Free, according to the decision of the constitutional Court of Ukraine from may 29, 2002 No. 10 RP/2002 means that the person must not reimburse the cost of medical care nor any payment, nor in any other form, regardless of the time of medical care. Prohibits the provision of the ability to provide the citizens with medical services that go beyond medical care, for a fee. According to the draft law on the state financial guarantees, medical care always and fully available to citizens at the expense of the state budget. At the primary level and in the event of an emergency, the state will pay 100% of all required treatment and, importantly, medicines in accordance with the detailed description. This will cover about 80% of all requests for medical assistance. In the secondary and tertiary levels, the government guarantees 100% payment of medical assistance and partial payment of other medical services and drugs included in the treatment. The bill does not provide for the recovery of citizens with no charges for the medical assistance they needed. Medical services beyond medical care at secondary and tertiary level can spsoperation government and the citizen (for example, through voluntary health insurance). For example, medical care during delivery is always covered by the state. However, spopulation be charged for a Deluxe private room or call a personal physician. Thus, SPOPAT will not be a barrier to obtaining assistance. Under the Bill, patients can get the care they need at the expense of budgetary funds among providers of medical services throughout Ukraine, regardless of place of registration according to the principle “money follow the patient” (unlike the current system, where people can receive free medical care only in those institutions in which it is “attached”). This will increase the availability of medical services for the population. Myth 7. Reform is not enough money Of course the reforms are not free. Will need investment to rebuild, refurbish, and re-profiling of hospitals. Will need separate investments in retraining of doctors. The owners of hospitals and other medical institutions – cities, districts, GSS is now interested in developing their medical infrastructure. Therefore, the Government decided to allocate for the refurbishment and conversion of institutions separate investment subsidy. In addition, the MINISTRY of health of Ukraine calculated the projected volumes of health expenditure according to the Calendar reform plan, which provides for consistent changes over the 2018-2020 biennium. According to preliminary data, during the period of expected stable growth of gross domestic product of Ukraine in average of 3.19% per year. The introduction of formal SPOPAT for medical services it is proposed to start gradually, with a gradual increase in the proportion of the relevant income with the expansion of services secondary (specialized) and tertiary (highly specialized) medical care will be provided by a new principle. According to the calculations, the share of expenditures on official SPOPAT will not exceed 13.3% of the total expenditure of the sector in 2020. Regarding the payment of the treatment itself, the most important thing is that now that our system has such a high level of inefficiency, starting money for a service for a real patient, will create for the same money much more health, treatment, prevention than it is now. But it is also important to increase resources for treatment are allocated from the budget. Myth 8. The reform will exacerbate the shortage of personnel, doctors still do not miss Reform rather create a financial motivation for young people to go into the medical profession. According to statistics, in Ukraine there were 31 doctor per 10 thousand population, which is comparable to European countries. However, there really is a certain imbalance in specialization. So, we have an excess of dentists, obstetrician-gynecologists and a shortage of family doctors and the like. Healthcare reform will resolve this problem, because paying for the service and a significant increase in salaries in primary care will remove the imbalance in the labour market. Myth 9. NCSU is a financial "monster", which will dispose of 80 billion UAH NCSU does not own these funds. The money accumulated in the state budget and kept in Treasury accounts. The national health service is a statement that contractual the purchase of healthcare services and signs contracts with medical institutions and doctors-FLP. The model of the National health service has the slightest risk of corruption, as it is the Central body of Executive power, will be controlled by the regulatory authorities such as the accounts chamber, KRU, and anti-corruption bodies of NABOO and NAPC. The law sets out a transparent procedure of selection of the head through the contest, which is similar to the choice of the head of NABOO. This is the fuse from NCSU headed by a person with a dubious reputation Myth 10. NCSU cannot provide services and to control their quality This is not so. Quality control services can be different – at the level of quality of care and level of compliance with the terms of the contract. If we are talking about the medical error, in this case, control remains with the body which grants a license for the Ministry of health. This was reported in the Zhytomyr regional state administration.Ïåðåâåäåíî ñåðâèñîì "ßíäåêñ.Ïåðåâîä÷èê": translate.yandex.ru.
Source: http://uzinform.com.ua/
