Kyiv, February 22. The current health care system is incapable of maintaining the nation’s health. Consequently, Ukraine must decide whether the country’s medical care should remain mostly the government’s responsibility or it should be yielded to the private sector, which supposedly provides better services for ensuring the nation’s health. This was stated by Natalya Izosimova, Director of the Foundation for Effective Governance, during the public debate “The state is a better provider of and investor in health care than the private sector”. The event was organized by the Foundation in partnership with Britain-based Intelligence Squared.

According to Ms. Izosimova, “The experience of different countries, for example, the USA and Canada, show that both private and public models of health care can be successful. However, in Ukraine we see a paradox: de jure, medical care is state-sponsored, but de facto, patients have to pay for their treatment from their own pockets. With this in view, the government has to make a choice: either to reform the country’s medical care, which was inherited from Soviet times, or to build a health care system from scratch”.

Ms. Izosimova also emphasized that quality medical care is one of the most important issues for any country. “Our nation has to be healthy, otherwise no reform will have any sense”, she explained.

During the debate, the advocates of state-sponsored medical care stated that the full commercialization of medical care could lead to the deterioration of the health of low-income population groups. It could also lead to the closure of economically inefficient hospitals in thinly populated areas. “The hidden agenda of many private clinics is to see their patients receiving treatment more often and to provide treatment that is more expensive but not necessarily more effective. This is while the government’s main goal is to have a healthy population. A healthy nation is a basic prerequisite of a country’s socio-economic development and a guarantee of the country’s national security and attractiveness for investors”, stated Tetyana Bakhteeva, Head of the Verkhovna Rada Health Care Committee, during the debate. In her opinion, only the government can ensure access to a certain level of medical services for every Ukrainian citizen, irrespective of his or her financial state.

The debate participants, arguing for a better perspective of private medical care, pointed to corruption in public medical facilities. “The insufficient financing of Ukrainian medical care for many years has led to the emergence of a shadow economy, surviving on formal or informal payments obtained from patients”, said Anatoly Zabolotny, Director of the Foundation for Development of Ukraine. He added that it is possible to radically improve the situation by lowering the level of corruption, prohibiting low-quality and inefficient medical products, utilizing medical equipment rationally, and withdrawing of the grey budget from the shadows.

Prof. Henry Marsh, founder of the International Center of Neurosurgery and member of London’s Royal College of Neurosurgeons, stated that “if the government has a monopoly on medical services, doctors and medical administrators may become corrupt”. At the same time, opponents of public medical care noted that corruption could also affect private medical facilities.

“It is important for Ukrainian medical care to learn the rules of civil competition: either among doctors or public and private medical facilities. The institute of medical ethics and responsibility is of paramount importance. The state has to be a regulator both for the private medical sector and for individuals, and also for the medical profession. These are the essential things that may help to protect patients’ rights. However, this system can only be effective if the authorities are not beset by corruption, and the country’s life is governed by the law”, said Prof. Marsh.

Despite the polarity of opinions, the debate participants agreed that the government must always play an important role in the country’s medical care system.