28.05.2012 - Здоров'я

Is insurance an oasis for a parient?

Health insurance price tag promises to revolutionize the services. We will not only receive care, “like in the movies,” but won’t pay for all the little luxuries. Already hungry for it? But is it as tasty, if you start eating?

Dozens of bills drop their slogans about the mandatory medical insurance, but as long as they are not destined to become a reality. But Article 49 of the Constitution of Ukraine is a train horn and rests to go away from the ground state of the legal document. “The state and municipal institutions of health care is provided free of charge; existing network of such institutions can not be reduced. The state promotes the development of medical institutions of all forms of property”, – he speaketh the truth. Experts from what is only the parties came to this position, to finally understand how these services are very bulky in vain, and eventually converge to the already realized all the everyday truth that free cheese is only in a mousetrap.

Ukrainians are more and more often faced with paying our “free” medicine. If the exchange for the services if you do not take the cash equivalent, then the chocolate, if not the chocolate, then coffee, and so, until imagine. Also, bring your medications, and even basic peroxide with a cotton wool. However, when looking at budget spending in this area, the place where miracles. Do not believe it! Expenses increased almost threefold over the past few years. Where, then, all of our “hard earned” disappear?

Just do not use their title. And it was not bribery or corruption (although this, too), but that is often given to the hryvnas is costly levels of care, which require expensive and sophisticated equipment, the contents of a large number of beds in hospitals, etc. And such areas as disease prevention, first aid, which require less cash infusion, developed a snail’s pace. And even if that funding is growing, it still remains at 3.4 % of GDP, and must be at least 5 %. There is also no clear list of health services themselves, which must be paid, not defined a guaranteed package of health care. In such circumstances, the doctor is not protected, and patients in no way assured.

This kind of collapse, where the unfortunate and the doctors who, having studied for 9-12 years in their specialty, janitors earn less for their services, and a pity, because you want to finally porcelain “like in the movies.” In order for you and have chosen, and a good word said they were drugs, and hospital or clinic does not look like after the war.

So, dreaming! But why not. Perhaps, after all MPs will finally draft Law of Ukraine “On obligatory state social health insurance” – and all will live better, all would be fun to live.

But you can not skepticism. It is clear that the transition to a paid medicine – and sooner or later it did happen! – The insurance will be part of such a reform. After all, it allows you to logically get out of situations where an urgent need money for treatment, but they are not. Finally, and doctors will be celebrating, because they each will pay for the work is not under the table, envelopes, cakes, coffees, and all legal, all with price tags will be.

On the one hand, who can be against such a fair justice? On the other, you begin to wonder, what do you do when your insurance will end? What if he will not cover those diseases that you have suddenly appeared?

And these questions are quite painful. Even in developed countries, all sung with that is not as smooth as we can see from a distance. By no means an isolated case is when, for example, a woman prays that before birth, because a week later she ends up insurance. Pay for medical services out of pocket is very expensive. And how many have heard about how “fast” the first thing asked when the call comes, there is a patient health insurance. And think a hundred times before you take on emergency care (!) If the answer is no. Such is our rosy dreams about health insurance? Probably not. I am sure it is not.

But the car does not stand still. Every day we are getting closer to that marketing oasis. In one of his interview with the chairman of the Parliamentary Committee on Health, Maternity and Childhood Mykola Polishchuk argues that in our legislation has long been a “loophole” (Basic Law of Ukraine about obligatory state social insurance, the Basic Law of Ukraine about public health and made them other regulatory legal acts) in order to do this. There are prerequisites for the development of primary health care, including through the Institute of Family Physicians. There is a decree of the Cabinet of Ministers.

Expert’s opinion

According to Tatyana Pasteur, Director of the Department of medical and life insurance company “Brokbiznes” voluntary health insurance (VHI) in Ukraine now covers only about 2 % of the population (mandatory, as already noted – no). In the market a lot of companies offering virtually the same services, because they work almost the same customers. Business insurance from year to year, but said that the pace of this growth is too rapid, it is impossible. It’s a very complicated type of insurance, and it is not profitable. Today it serves more as a key confidence for the client. After all, when people entrusted you with their health, confidence and car insurance, apartment, etc.

“You probably know this expression, we do not have healthy, we have a poorly surveyed. And when people objectively look at your health and decide to tackle the problems of dentistry, for example, they will be much more and the price is much higher than it can afford. We have the same people go to the doctor only in emergency cases. When a person has health insurance, he understands that when you contact the insurance company has no right to refuse him, and in any case, his visit to the doctor will be paid. Some of these are very successful, “- says the expert.

VHI  programs offer a common set of services and may consist of many options. The main ones are: covering the cost of medicines in hospital and clinic, the actual service clinics, counseling specialists, laboratory and instrumental methods of investigation and all the other tests that are necessary for diagnosis. Also included is an emergency and acute care hospital, her call. These services are essential, which are present in almost all children’s and adult programming packages. More than 25 such functions and can be added if desired.

Also, Ms. Paster argues that voluntary health insurance is often used by corporate clients. Here, the principle of “healthy pay for the patient”. After all, if a team of one hundred and one people one gets to the hospital, the rest will pay for the one who really was a trouble.

In turn, individuals are rarely used in Ukraine, insurance companies, and they were not very eager to cooperate. We want to pay less and get to the full.

“In order to introduce a mandatory type of insurance, must pass a thorough reform and, above all, we should adopt a new vision of medicine as a whole. Indeed, to date, our health care system is in such condition that we are as ordinary citizens come to the hospital and pay the same money, but there will be no ultrasound machine or other equipment necessary nor the laboratory. We have, as before, the medicine in the country funded by the residual principle “- said the representative of the insurance company.

Health Insurance

At a time when the fate of mandatory health insurance has not been solved in our country is also actively approved health insurance. It provides in case of problems, patient medication helps in laboratory studies, and in case of surgical intervention – consumables.

Operating such a system is quite simple: the members of the health insurance fund (and often are employees of certain agencies) to pay its contributions to the fund at a rate of 30, 40 or 50 hryvna per month. Then, when they need to be drugs, cash buys them. It can also pay for the services of the clinic, where, in fact, functioning. Total for the year you are given the hryvna in 1500, and if suddenly you for such a sum “pent up”, she turns to January 1 pumpkin that is consumed. Interesting system, you will agree.

In addition, members of one of capital banks were told that they came back to say the least, voluntary and forced. Another told me some “subtleties” of the system. It turns out that drug, if you are going to buy them through an organization, are more expensive than the drugstores. And the service you will be reimbursed if something is not the full amount – that’s for sure. And finally, what is there to be surprised? We did not warm up your hands on something considered mauvais ton.

Generally, these structures can not be an alternative to health insurance. Why, then, is to build a hospital that would be saved from all diseases, and would have had any equipment. Yes, and treat, in fact, you can just it. Because no other medical facility of your contributions have never seen you there and pay will be “like all mortals.”

Bottom view

Dentist Larissa Zakrevskaya also refused to join their health insurance, without seeing in it the necessary assistance. She also told her about the known cases, a kind of “street magic” in the medical institutions of the capital.

It turns out that they do not conjure worse health insurance, creating for customers with insurance and other “price.” Therefore, in order, for example, treat your teeth, you is 10-thousand hryvna, under policy, will not suffice. We’ll have to pay extra, which helped.

“Do not take root, we like innovation, – assured Mrs Zakrevskaya. – Everything is too corrupt. Is that the future will be able to resolve all legal. “

Instead of an epilogue

Ministry of Health notes that an alternative to health insurance and never will. Of course, you must first reform of the global health system. Even after this should develop and implement a mandatory health insurance. It is clear that this process will not be painful. However, if our people paid into such funds have, for example, 40 years and we have a clear understanding on what needs, what hospital, what region and what kind of equipment does the money go, then medicine, to believe the experts, turned to face the people .

The progress and advancement are rooted in the near future we will have to feel for yourself that this is insurance and what it eats. The main thing is not to suppress citizens overseas a cooked meal and she was right and wrong as always – saving money on ingredients.

Volodymyr Malynka