The Ukrainian constitution guarantees, in theory, that free medical treatment will be available for all Ukrainian citizens and registered residents. In practice however, public funds remain limited for health care, the free services can only cover basic provisions leaving patients to pay out-of-pocket for most medical services and pharmaceuticals. As a result, the promise of free medical care has increasingly been replaced by chargeable care. Some attempts have been made in recent years to improve the funding infrastructure by introducing an obligatory public health insurance scheme but such legislation remains gridlocked in parliament.
The Ministry of Health is responsible for setting national health policy and oversees the healthcare system in Ukraine. Public health services are administratively centralized and vertically organized. The country is divided directorially into 27 regions, each with its own health administration that is accountable to the national authority for following managerial guidelines. Most health care facilities are state owned and operated at the regional or local level and are funded through the respective tier of government with which they are associated. Financing of the healthcare sector remains unchanged from the Soviet era’s tax-based approach. Health budgets are often planned according to line items and allocated centrally without taking the needs of local populaces into account. The current system of payment of hospitals and polyclinics offers little incentive to operate and use public resources efficiently.
Ukraine inherited a health infrastructure that prioritized excess hospital capacity and specialized care over necessary public health promotion and preventative treatment centers. The inpatient system is organized into three levels. Primary care is provided through a network of small hospitals and polyclinics. The area serviced by a primary health clinic is broken up into catchment areas each with a certain number of residents and a primary care physician. Citizens are allowed to register with the doctor of their choice; however bureaucratic obstacles prevent this for many. The second level comprises municipal and central rayon, or district, hospitals. There is no strict distinction between primary and secondary care in Ukraine. Patients can seek care with a specialist directly, without referral, and this opportunity is widely used. The incentive system in fact encourages this as physicians are remunerated at fixed rates regardless of their workload and do not therefore compete for patients. Larger cities in Ukraine will have specialized state hospitals, most often for communicable diseases, as well as maternity hospitals. Tertiary care is provided by oblast hospitals and specialized clinical and diagnostic centers of national research institutes. State healthcare facilities, particularly in rural areas, suffer from outdated equipment and dilapidated structures. Private clinics are available in major cities and will offer further diagnostic and higher quality services but remain unaffordable for the majority of the populace.
Travelers and expatriates visiting Ukraine are advised to take out a comprehensive international health insurance policy before arriving in the country. Ukraine’s state medical care facilities may be adequate for routine problems, but are not comparable to Western European or North American standards of medical care. Most doctors and hospitals will expect payment upfront in cash and medical supplies may be limited. If you are hospitalized, you may have to supply your own bandages, medication, and food during your stay. Private clinics and hospitals may avoid these issues but will be a more expensive option. The disparity of the accessibility and quality of healthcare between rural and urban areas is substantial in Ukraine. If you become seriously ill or injured in a rural area or if the treatment or medication you require is not available in the country, medical evacuation may be required. This can be a very expensive service in a time-sensitive situation, so it is imperative that your travel health insurance policy covers emergency evacuation transportation costs.
Pacific Prime will consult and offer a wide range of policies to meet your individual needs should you plan to travel to Ukraine. We offer a wide variety of health care plans and travel insurance policies with possible benefit packages including dental, maternity, inpatient, outpatient, specialist consultations, and many more. Please contact our professional advisors today for a free quote and enjoy the security that our extensive Global Health Insurance Plans can provide.