Doctors, not politicians, should talk about health care reform in Ukraine
Recently, social networks have once again raised the issue of health care reform. This topic is surprisingly fruitful for all kinds of public speculation, lightning-fast dispersal of unreliable information or primitive fakes.
Such actions take place regularly. But one thing continues to surprise me: we demand quality medicine, we want it to be “like in Europe”, but we do not feel the desire to understand what is happening. To understand how it works for them, to move away from the model of the Soviet health care system with all its unconditional advantages, which, together with the remnants of the Union, have rested for more than a quarter of a century.
We are not ready to support changes regarding the launch of complex reforms, because a person is arranged in such a way that his psychological thinking resists innovations and does not welcome hesitation.Therefore, we follow the path of least resistance and happily pick up the next wave, unconsciously supporting someone’s interests that are far from the people and reason like this: “Some official is not coping? So let’s find a replacement!” After that, we happily sit down, fold our arms like those of “Zhdun” and plunge into a state of pleasant anticipation of that bright moment when the standard of living and medical care in Ukraine will finally be “like theirs.”
I want each of us to look around and realize – “how they have” will not be for a long time or will never come if we just talk and criticize. Each of us will become an important link in the social development of the country if we start small – with ourselves and those around us. He will look for a rational grain in any information “stuffing”, analyze the experience of states mentally and geographically close to Ukraine. And do not rush from one extreme judgement to another after one more loud (and, frankly, poorly grounded) headline.
Along with the judicial, pension and education reform, changes in the national health care system stand apart. There are people who were fortunate enough to never cross the threshold of the courthouse in their entire lives, but there is not a single person who has not turned to doctors for help. Therefore, any Ukrainian is interested in high-quality and affordable medicine: for himself, for his family and friends.
The results are obvious
The first thing that has changed in the health care system of Ukraine over the past year or two is the distribution of funds. Decentralization has brought its results, so medicine is now funded under various programs from the central and local budgets. This means that it is important for local officials to understand what problems there are in the region with hospitals, medicines, equipment, and how many patients require constant medical care and assistance.
Dividing the budget into general and additional would play an important role here. For example, in 2018, each medical institution would sum up the expenses: how much was spent on household and communal needs, how much was spent on salaries for doctors, the purchase of medicines, equipment and repairs. The result would be a certain amount, thanks to which it immediately becomes clear that the budget for next year should be larger, taking into account the increase in the minimum wage, utilities and inflation. I would like to note that all these expenses are well understood by local specialists, chief doctors and accountants, and the Ministry of Health has nothing to do with them.
This is the overall budget. And, in my opinion, no significant changes have been made to it since the times of the Soviet Union. An additional budget can be obtained within the framework of the local budget program, the Cabinet of Ministers, or by asking to allocate a social help (money from a special fund) from people’s deputies. This is how the public administration system works.
Of course, on the way to providing hospitals with everything they need, there is a high probability that they will face opaque funding. It is possible that the cost of repair work or the purchase of equipment will be overestimated, the tender will be held on the principle “for their own”, or the doctor will transparently hint to the patient about gratitude for the consultation. But this is a human factor. We will have to cope with it in two ways, introducing the rule of honesty into life and ensuring a decent level of official income for the doctors to whom we trust our own health and lives.
What did the reform itself give?
First of all, it clearly showed how unviable the national health care system is, despite the fact that for many years we have lived just by such rules. Secondly, time goes forward, new challenges appear – and they have to be met.
But the human factor is the most important thing that the reform did not take into account.
Why do I pay special attention to it?
How it happened: the Ministry of Health proposed legislative initiatives, deputies made amendments and voted for medical reform, as a result of which a new structure was created – the National Health Service of Ukraine (NHSU). They shared responsibilities and gave their blessings… Then, the reform “goes down”, so at the local level, officials must study what its essence is, how and in what time frame to introduce certain stages of the reform. What instructions should be given to doctors, who are the most important link in this whole process. And how to implement the necessary procedures and algorithms.
The logic is broken here: it is medical workers who should talk about the advantages of innovations and state the shortcomings so that officials have the opportunity to correct them. But it turns out the other way around, which significantly reduces the effectiveness of the change and increases the number of flaws.
While supporting hospitals and helping them with the necessary medical equipment, I have often come across the fact that they often lack information. Therefore, in November last year, my team organized and held a large medical forum in Kiev, which launched an information campaign for doctors, the public and the population.
This year, the NGO “Innovation Leadership Foundation” will hold similar forums in a number of regions of Ukraine in order to give the floor to doctors, to hear experts. Share practical cases to ensure that the reform of the domestic health care system is as effective as possible, balanced, without misinterpretation and speculation. High-quality, timely and affordable medicine in Ukraine is our common cause.
I urge you not to criticize officials, but to join the process and help them carry out the reform. We have lived for a long time in anticipation of a miracle, but from the word “reform” or the adopted law expectations, unfortunately, will not become reality. But from the efforts of not indifferent people, they will. I believe in our country, and in the fact that everything can be changed for the better if each of us makes an effort and does what is in his power.
The Medical Forum is a mobile, modern platform for communication, dialogue and constructive discussion. Experience shows that it is better to work together to develop effective tools for the successful implementation of health care reform than to endlessly blame each other on the public dishonesty. At the same time, say goodbye to the dream of high-quality medicine, accessible to people of different social status and different income levels. Say goodbye to the dream of a strong, healthy nation.
In 2019, the medical forum will visit the regions. Let the truth about our medicine become a challenge for those who speculate on the topic of medical reform on TV and in social networks. And it will become a support and a working platform for those who are ready to take responsibility for the decisions made and the future of our country.
https://24tv.ua/ru/andrej_docenko_tag5758