Ukrainian healthcare is run by the ministry of health and all working citizens are required to contribute to its cost. The Ukrainian public health is still under transition from the past soviet-dictated health where capacity used to be everything. This system was characterized by high numbers of beds and physicians. It used to be among the best health systems in Europe, but not in terms of overall standards. This is demonstrated by the relatively low life expectancy of 71 years among men with women expected to live 10 more years. Private Consultants and doctors also charge for health services provided. Nevertheless, the cost of medical services in Ukraine is relatively affordable in both public and private health sectors compared to other countries in Europe. This article reviews the cost of various medical services in Ukraine in both public-private health sectors.
- Cost of public medical services
Theoretically, Ukrainian healthcare is free of charge to all citizens. It is important to note that Ukrainian health coverage is governed by the Constitution (Article 49) which entitles all citizens to health services provided by governed-and community-owned health facilities. These services charge no costs and are supposed to be provided without limits on the volume of care provided. However, Ukraine has not been able to come up with strategies for allowing publicly funded health benefits to reach the most vulnerable populations. This resulted in many health services provided by public healthcare facilities being rationed based on whether people can afford them by paying for them out of pocket. Consequently, these free services only covered basic provisions with patients often being required to dig into their pockets to cater for extra costs for specialized equipment during surgery. Therefore, publicly funded medical coverage used to be extremely limited in Ukraine, and people paid out-of-pocket to receive most inpatient and outpatient services. Besides, most of the payments for most medicines were based on out-of-pocket due to various factors including low levels of public health spending, inequality, and inefficiency in the allocation of expenditure of public resources.
Nevertheless, the Ukrainian public health sector has undergone rapid transformation in recent years with the aim of providing citizens with equal access to quality medical care and a shift towards a patient-oriented approach. Some of the key results of these transformations are as follows. The Ukrainian government launched Specialized Healthcare Guarantee Programme (SHGP) in April 2020 which offers specialized care under National Health Insurance Fund (NHIF). By September 2020, the NHIF had entered into contracts with more than 3,000 healthcare providers with payments amounting to UAH 51.6 billion for services rendered to patients under the SHGP.
More than 1,600 primary care providers have signed contracts with the NHIF including 300 self-employed doctors, 200 private sectors, and 1100 municipal health facilities. The number of primary care physicians has increased from the beginning of 2020. Currently, the public health sector plays a crucial role in the fight against the Covid-19 pandemic. More than 290,000 patients received specialized priority health services between April and August 2020, with more than UAH 2.7 billion being paid to various healthcare institutions for providing priority services. Currently, the SHGP also incorporates the affordable medicines reimbursement program that allows patients to receive prescription drugs for bronchial asthma, type II diabetes, and cardiovascular disorders for free or with a small co-payment. Moreover, this program allows patients to get more than 260 prescription drugs, 85 of which are free. In addition, this program has allowed patients to receive medications from more than 8,500 partner pharmacies across Ukraine.
Tuberculosis and mental health services almost shut down in Ukraine due to funding shortages in the past. However, the ministry of Health formulated regulations and reviewed medical service costs to prevent the closure of healthcare facilities and the dismissal of medical practitioners providing these services. Since July 2019, the ministry of health has funded these health services with anti-tuberculosis treatment being introduced under SHGP in 2020. Concerning mental healthcare, the ministry of health has cooperated with experts in the development of a mental health plan to cater to Ukrainians.
- Cost of Private medical services
Private healthcare provision is one of the areas Ukraine has excelled at, attracting a high number of medical tourists. Whereas Ukraine is ranked among the top-ten most visited destinations due to its rich heritage, cultural tradition, and natural beauty. Healthcare tourists in Ukraine enjoy the highest standards of expertise and medical care equipment at relatively low costs compared to other nations. Ukraine provides high standards of private cosmetic surgery, and dentistry alongside other medical treatments at significantly low costs compared to other nations, with almost no waiting time. The quality of dental care and cosmetic surgery in Ukrainian private hospitals are equal with the top providers in Europe but cost about a fifth of the price. The site experts Finance.ua found that for instance, the cost of a dental crown in Ukraine can go for €125 with breast reduction surgery going for as low as € 1,500.
Ukraine has also become well known for its specialized centers for laser and eye surgery which cost about €1,500. Moreover, Ukraine is among the few countries that provide international surrogacy with Ukrainian women offering surrogate mothers egg donation services at a fraction of what it would cost elsewhere in Europe with a short waiting list. For instance, the cost of In-vitro fertilization (IVF), Frozen embryo transfer (FET) IVF with egg donation, and embryo donation are € 3,187, € 3,360, € 6,008 €6,720, and €7,200, respectively.