If Ukraine’s Economy Is to Reform, Then Its Inefficient Health System Has to Go – The National Interest Online (blog)
The United States is not the only country caught up in an emotional debate over health care. The Ukrainian Rada (parliament) has been struggling with the issue for months. And like their counterparts in the U.S. Senate, Ukrainian lawmakers scuttled plans to pass health-care reform just before breaking for summer recess on July 19.
In Ukraine, however, the stakes for reform are higher. For starters, more than 90 percent of Ukrainians have no medical insurance. But the problems go far deeper than that.
The countrys current health-care system is a legacy of the Soviet eraand a most sorry one. Government funding and resources for hospitals are allocated according to the number of medical workers, buildings and beds, rather than the number of patients treated. Physicians and administrators, saddled with a mind-set stuck in the Soviet way of doing things, shun more advanced Western practices and equipment.
The carry-over egalitarianism of the Soviet era leaves doctors earning a paltry $200 a month. Naturally, this breeds corruption. For example, bribery is a commonplace precondition for receiving medical treatment. The situation is dire.
So dire, in fact, that International Monetary Fund (IMF) has insisted that Ukraine reform its health system. The IMFs program to keep the Ukrainian economy afloat is contingent on significant economic reforms, including fixing the corrupt and inefficient health system.
The big stumbling blocks have been the entrenched corruption and Soviet mind-set of Ukraines older generation of political leaders.
But leading the charge for reform is a relative newcomer, Dr. Ulana Suprun, Ukraines Acting Minister of Health.
Born, raised and educated in the United States, Dr. Suprun had a successful radiology practice in New York City. When the Maidan revolution erupted in early 2014, the Ukrainian-American physician traveled to Ukraine to treat those wounded by the security forces of former President Viktor Yanukovych.
Then, when Russian proxies in Eastern Ukraine, backed up by regular Russian troops and equipment, started an insurrection against the central government, Dr. Suprun moved to the frontlines of the conflict, providing lifesaving care and NATO standard Combat Lifesaver training to soldiers.
In 2015, a thankful Ukrainian president, Petro Poroshenko, conferred upon her Ukrainian citizenship, saying during the ceremony: Your efforts saved thousands of lives. In August 2016, she was asked to become the acting Minister of Health.
Under her leadership, the government has rooted out a significant amount of corruption from the health-care sector. For example, by changing the way the Ministry of Health procures pharmaceuticals, the department cut those costs by 40 percent. But more needs to be done.
The reform Suprun was pushing this year aimed to raise the level of Ukrainian health care to international standards. It would, for example, require medical licenses for individual doctors. Currently, only medical practices are licensed and they can hire doctors straight out of medical school, with no clinical training or experience.
The reform bill currently up for a vote in parliament would also change the way hospitals are funded, linking the money more closely to actual delivery of patient services. And it would close down or consolidate hospitals that arent treating enough patients to remain cost effective and provide quality services.
As if that werent enough, the proposal would have: reformed palliative, emergency and primary care simultaneously; freed doctors to earn more money in an open, transparent manner so they would not have to resort to bribe-taking to generate additional income; and provided universal health care coverage for all Ukrainians.
The ultimate goal of the reform package was to empower patients, giving them new rights and protectionsa noble ambition. No wonder the G7 Ambassadors to Ukraine endorsed the proposal, calling it a sign that Ukraine is ready and committed to moving forward with its vital reforms, in health care and anti-corruption, for the benefit of its citizens.
In many ways, the health-care debate is emblematic of the larger societal struggle in Ukraine. Its the younger generation of technocrats fighting against the old guard. Its the new Western way of thinking against the old Soviet way of doing business.
The old guard in the Rada was able to block Supruns reform bill from coming up to a final vote just before the summer recess. But thats not necessarily the end of this fight. The Rada will have another chance to vote on it when lawmakers reconvene in September.
The outcome of the health care vote will likely chart the future policy direction of Ukraine: whether it will remain stuck in its failed Soviet past or move toward a brighter future in the Euro-Atlantic community.
Luke Coffey is director of The Heritage Foundations Allison Center for Foreign Policy Studies.
- Russia issues school textbook saying it was 'forced' to march into Ukraine - Reuters - January 27th, 2025 [January 27th, 2025]
- Russia introduces history textbook that redefines war against Ukraine as justified defense. - Kyiv Independent - January 27th, 2025 [January 27th, 2025]
- Bad Things Happened: Trump Still Doesnt Understand the Ukraine War - The Bulwark - January 27th, 2025 [January 27th, 2025]
- Russia says its troops have captured a strategic town in eastern Ukraine - The Associated Press - January 27th, 2025 [January 27th, 2025]
- NATO chief: Cost of Russian victory in Ukraine would be trillions not billions - Atlantic Council - January 27th, 2025 [January 27th, 2025]
- For Russian Forces In Ukraine, Its Now Normal To Ride Into Battle In A Compact Car - Forbes - January 27th, 2025 [January 27th, 2025]
- Opinion: Trump promised to end the Ukraine war, but neither side is ready - Los Angeles Times - January 27th, 2025 [January 27th, 2025]
- Putin echoes Trump's claim that conflict in Ukraine could have been avoided had he been in office - The Associated Press - January 27th, 2025 [January 27th, 2025]
- Russia says it sees no signs that Ukraine and the West are ready for peace talks despite all statements - Reuters - January 27th, 2025 [January 27th, 2025]
- Zelenskiy says Trump could end Ukraine war only if Kyiv included in talks - Reuters - January 27th, 2025 [January 27th, 2025]
- War in Ukraine: EU to Agree to Extend Russia Sanctions, Hungary to Back Down - Bloomberg - January 27th, 2025 [January 27th, 2025]
- Letters: Stop the fireworks; angry about McCoy story; end war in Ukraine - VC Star - January 27th, 2025 [January 27th, 2025]
- Zelenskiy Says Ukraine Ready to Transit Gas From Azerbaijan - Bloomberg - January 27th, 2025 [January 27th, 2025]
- Why peace talks between Ukraine and Russia are not as simple as Trump makes out - The Independent - January 27th, 2025 [January 27th, 2025]
- Trump tells Putin to end 'ridiculous war' in Ukraine or face new sanctions - BBC.com - January 26th, 2025 [January 26th, 2025]
- Ukraine-Russia latest: Putin ready for Trump negotiations as Kyiv sets oil refinery ablaze with drone strike - The Independent - January 26th, 2025 [January 26th, 2025]
- Ukraine is reforming its recruitment efforts to attract younger soldiers and boost forces - The Associated Press - January 26th, 2025 [January 26th, 2025]
- Europe considers sending troops to Ukraine if theres a ceasefire. But would Russia accept? - The Associated Press - January 26th, 2025 [January 26th, 2025]
- Opinion: I spent Trumps inauguration in Ukraine. This is what I saw. - Salt Lake Tribune - January 26th, 2025 [January 26th, 2025]
- Putin claims Ukraine crisis may have been averted if Trump was president - CNN - January 26th, 2025 [January 26th, 2025]
- Did Ukraine Kill Its Own by Downing a Russian Plane? A Year Later, It Hasnt Said. - The New York Times - January 26th, 2025 [January 26th, 2025]
- Russia claims its troops are in the last stages of taking another eastern Ukraine town - The Associated Press - January 26th, 2025 [January 26th, 2025]
- Ukraine Is Losing Fewer Soldiers Than Russia but Its Still Losing the War - The New York Times - January 26th, 2025 [January 26th, 2025]
- Does Putin know why Ukraine fights on? Because we prize freedom above stability and wealth | Andrey Kurkov - The Guardian - January 26th, 2025 [January 26th, 2025]
- Russia rejects idea of NATO peacekeepers in Ukraine, warning of "uncontrollable escalation" - Reuters - January 26th, 2025 [January 26th, 2025]
- Trump's threat against Moscow on Ukraine seen as an insulting false start by some in Russia - NBC News - January 26th, 2025 [January 26th, 2025]
- UKs 100-year partnership with Ukraine is a meaningless political stunt - Al Jazeera English - January 26th, 2025 [January 26th, 2025]
- Putin says he and Trump should meet to discuss Ukraine and energy prices - Reuters - January 26th, 2025 [January 26th, 2025]
- Putin ready for negotiations with Trump on Ukraine war - The Guardian - January 26th, 2025 [January 26th, 2025]
- US arms exports hit record in 2024 on Ukraine-related demand - Reuters - January 26th, 2025 [January 26th, 2025]
- This Ones Mine. Ukraine Says Russia Is Executing More POWs and Capturing It on Video. - The Wall Street Journal - January 26th, 2025 [January 26th, 2025]
- Russia Brushes Off Trumps Threats on Ukraine - The Wall Street Journal - January 26th, 2025 [January 26th, 2025]
- Russia: Nothing new in Trump threats on Moscows war on Ukraine - VOA Asia - January 26th, 2025 [January 26th, 2025]
- Video: The Kremlin responds to Trump calling on Putin to make a deal with Ukraine - CNN - January 26th, 2025 [January 26th, 2025]
- To end the Russia-Ukraine war, Trump will need to get leverage - The Hill - January 26th, 2025 [January 26th, 2025]
- Ukraine's Kursk invasion was a risky play, but it might have nailed the timing - Business Insider - January 26th, 2025 [January 26th, 2025]
- Trump leans in on targeting Russian oil revenue as he tries to fulfill pledge to end Ukraine war - The Associated Press - January 26th, 2025 [January 26th, 2025]
- 'He shouldn't have done that': Donald Trump criticizes Ukraine president over war - USA TODAY - January 26th, 2025 [January 26th, 2025]
- Putin open for talks with Trump over Ukraine war and calls for leaders to meet - The Independent - January 26th, 2025 [January 26th, 2025]
- Business elites truly believe Trump could be on the verge of solving one of the world's most difficult problems: The Ukraine War - New York Post - January 26th, 2025 [January 26th, 2025]
- Kyiv investigates another case of Russian soldiers executing Ukraine POWs - POLITICO Europe - January 26th, 2025 [January 26th, 2025]
- Ukrainian winemaker and US veterans team up to show the best of Ukraine, a glass at a time - The Associated Press - January 26th, 2025 [January 26th, 2025]
- Is Trump changing tack on ending the war in Ukraine? - The Conversation Indonesia - January 26th, 2025 [January 26th, 2025]
- Shared Challenges: Israel Considers Sending Russian Weapons Seized From Hezbollah to Ukraine - Foundation for Defense of Democracies - January 26th, 2025 [January 26th, 2025]
- Ukrainian troops say inexperienced North Koreans are making easy targets - The Washington Post - December 16th, 2024 [December 16th, 2024]
- Ukraine says it has laser weapon able to down targets flying at over 2km - Yahoo! Voices - December 16th, 2024 [December 16th, 2024]
- Berlin eyes role in Ukraine peace deal but says too early for decisions - Reuters - December 16th, 2024 [December 16th, 2024]
- Keep Ukraine Out of Talks to End Its War - Foreign Policy - December 16th, 2024 [December 16th, 2024]
- Ukraine and US say some North Korean troops have been killed fighting alongside Russian forces - The Associated Press - December 16th, 2024 [December 16th, 2024]
- Russia aims to win the war in Ukraine in 2025, top official says - Semafor - December 16th, 2024 [December 16th, 2024]
- Trump suggests reversing permission for Ukraine to use US missiles in Russia - The Telegraph - December 16th, 2024 [December 16th, 2024]
- Trump to Europe: Overseeing a Ukraine Cease-Fire Would Be Your Job - The Wall Street Journal - December 16th, 2024 [December 16th, 2024]
- The Price of Russian Victory: Why Letting Putin Win Would Cost America More Than Supporting Ukraine - Foreign Affairs Magazine - December 16th, 2024 [December 16th, 2024]
- They said we were American spies: Priests describe Russias crackdown on Evangelicals in occupied Ukraine - CNN - December 16th, 2024 [December 16th, 2024]
- Trump says it was 'stupid' for Biden to let Ukraine use US weapons to strike deeper into Russia - The Associated Press - December 16th, 2024 [December 16th, 2024]
- Cajole, Plead and Flatter: Ukraine Makes Its Case to Trump - The New York Times - December 16th, 2024 [December 16th, 2024]
- Ukraine-Russia war map: Where Putins forces are making gains in eastern Ukraine - The Independent - December 16th, 2024 [December 16th, 2024]
- Europe Needs to Swiftly Fulfil Its Aid Pledges to Ukraine - Bloomberg - December 16th, 2024 [December 16th, 2024]
- Ukraine says it has laser weapon able to down targets flying at over 2km - Reuters - December 16th, 2024 [December 16th, 2024]
- Trump says deal needed to stop Ukraine war, will talk to Putin and Zelenskiy - Reuters - December 16th, 2024 [December 16th, 2024]
- Were 750,000 additional lives wasted in Ukraine for less than nothing? - The Hill - December 16th, 2024 [December 16th, 2024]
- Ukraine war: US gives $20bn to Kyiv funded by seized Russian assets - BBC.com - December 10th, 2024 [December 10th, 2024]
- Trump calls for immediate ceasefire in Ukraine and says a US withdrawal from NATO is possible - The Associated Press - December 10th, 2024 [December 10th, 2024]
- How Trump Can Win the Peace in Ukraine - The Atlantic - December 10th, 2024 [December 10th, 2024]
- Ukraine-Russia latest: Zelensky wont sacrifice young troops to Putins forces for more weapons from West - The Independent - December 10th, 2024 [December 10th, 2024]
- Biden is rushing aid to Ukraine. Both sides are digging in. And everyone is bracing for Trump - The Associated Press - December 10th, 2024 [December 10th, 2024]
- Russian prison boss killed in car blast in occupied Ukraine - BBC.com - December 10th, 2024 [December 10th, 2024]
- Kremlin says Ukraine war will go on until Putin's goals are met on battlefield or by negotiation - Reuters - December 10th, 2024 [December 10th, 2024]
- Russia targets Ukraine's energy grid as winter sets in. Here's how one plant copes - NPR - December 10th, 2024 [December 10th, 2024]
- Deadly Russian strike kills at least three in Ukraine's Zaporizhzhia - Euronews - December 10th, 2024 [December 10th, 2024]
- How Trump Could End the War in Ukraine - The Atlantic - December 10th, 2024 [December 10th, 2024]
- War in Ukraine: The woman turning amputees into 'superhumans' - BBC.com - December 10th, 2024 [December 10th, 2024]
- Zelensky salutes Trump's 'strong resolve' to end war in Ukraine - FRANCE 24 English - December 10th, 2024 [December 10th, 2024]
- US announces nearly $1 billion more in longer-term weapons support for Ukraine - The Associated Press - December 10th, 2024 [December 10th, 2024]
- Amid U.S. pressure, Ukraine starts thinking about drafting 18-year-olds - The Washington Post - December 10th, 2024 [December 10th, 2024]
- Zelenskyy open to Western troops providing security for end to war in Ukraine - The Associated Press - December 10th, 2024 [December 10th, 2024]
- Ukraine to raise NATO invite, security guarantees at meeting with European allies - Reuters - December 10th, 2024 [December 10th, 2024]
- Kyiv reveals total Ukraine casualties in Putins war for first time - POLITICO Europe - December 10th, 2024 [December 10th, 2024]
- Bill Browder on saving Ukraine, NATO, and the threat of Vladimir Putin - the1a.org - December 10th, 2024 [December 10th, 2024]
- Biden is rushing aid to Ukraine as everyone braces for Trump - FOX 5 DC - December 10th, 2024 [December 10th, 2024]