The state to help: can quality and modern medicine be free
Modern medical technology requires significant funding and costs. And often, these costs are borne by ordinary people. The task of the state is to make financially accessible for citizens highly specialized treatment at the expense of new financial instruments. Deputy Minister of Finance of Ukraine Roman Yermolychev told in an interview to the Fund about the Medical Guarantees Program and state funding of certain branches of medicine.
"Today, the state is making every effort to increase funding and provide citizens with quality medical services,"- Roman Yermolychev, Deputy Minister of Finance of Ukraine.
Roman Volodymyrovych, tell us, how and to what extent in 2021 is the state funding of compensation for hearing loss in children?
First of all, I would like to draw your attention to the fact that in 2021 the funding of hearing loss compensation was continued, because in fact a comprehensive solution to this problem began in 2018, when the Ministry of Finance initiated care in this area. A few years ago, there was a great need for these specialized medical services, because the state funds for hearing aids were not provided by the budget, while the queue for the operation was about 400-450 people. If we add to the problem of lack of funding well-founded medical recommendations on the need for timely compensation for hearing loss in children (for example, the deadline for medical intervention, including rehabilitation of the child and successful social adaptation - up to 5 years) ... the need needs to be addressed at the state level as soon as possible.
It is clear that not everything worked out at once: for several years we cooperated with the National Academy of Medical Sciences of Ukraine and the Institute of Otolaryngology. prof. OS Kolomiychenko National Academy of Medical Sciences of Ukraine. Almost every week, representatives of the Ministry of Finance held meetings to resolve current issues with specialists in the field, and finally, together, we have established this process in Ukraine. It is worth noting that the 2021 budget provides 360 million hryvnias of state funds for implantation hearing aids for children and adults who are in line.
That is, the funding program also covers citizens over the age of 18?
For the past two years, funding for hearing loss compensation has been closed for both children and adults. The price of cochlear implants, which stimulate the fibers of the auditory nerve with electrical impulses, is quite high - one device costs about 750 thousand hryvnias; a speech processor that transmits impulses (sounds) directly to the cochlear implant costs 285,000 hryvnias. We understand that for people these are unaffordable sums, and therefore, the task of the state is to provide financial assistance to its citizens. In 2021 alone, 58 children and 21 adults were operated on, as well as additional speech processors for the cochlear implant system for 35 children and 7 adults. And if we talk about the queue, it currently consists of 56 children and 80 adults for cochlear implantation and 41 children and 5 adults for speech processors. Comparing the figures that were a few years ago, it is no longer 450 people. But it should also be noted that the queue is formed not because the Ministry of Finance can not provide "instant" funding for hearing aids for all at once, but because according to medical indications, the person in the queue needs a thorough diagnosis. Therefore, doctors need about six months to collect a medical history, examine the patient, check whether the implant will take root and only then operate.
It is clear that charitable foundations are still involved in hearing aids. However, a few years ago, almost all funding was in the area of responsibility of philanthropists and philanthropists. To date, this issue has been resolved by the Government, and charities can now focus more on other areas of assistance.
What are the current prospects for public funding for cardiology in Ukraine?
It should be noted that in April 2020, Ukraine began to reform the secondary care: secondary hospitals provide more specialized services, including in the field of cardiology, and the cost of these services, if they are part of the Medical Guarantee Program - free of charge for the patient . The Medical Guarantees Program includes municipal medical institutions that cover the needs of medical care in the field of cardiology in the regions.
In addition, there are 4 state institutions of cardiology of the Ministry of Health and the National Academy of Medical Sciences of Ukraine, namely: Institute of Heart of the Ministry of Health of Ukraine, Scientific and Practical Medical Center of Pediatric Cardiology and Cardiac Surgery of the Ministry of Health of Ukraine, Institute of Cardiology MD Strazheska and National Institute of Cardiovascular Surgery. MM Amosov National Academy of Medical Sciences of Ukraine.
For example, in the case of such institutions of medical sciences as the Institute of Cardiology named after Academician MD Strazhesk and the National Institute of Cardiovascular Surgery. MM Amosov NAMS - for them in the budget of 2021 provided 306 million hryvnias, and 130 million hryvnias, this year allocated for updating the material and technical base of these institutions. If we talk about the average cost of the service provided by these institutions, it is about 100 thousand hryvnias. I emphasize that the state clearly pays these funds at the rate of the above-mentioned institutions. Imagine a person coming to the Institute. MM Amosov or Institute. MD Strazheska on referral (this is a standard procedure in medicine), and in this case the state covers the cost of treatment.
What about other areas? What other areas does the Medical Guarantee Program cover?
Last year, the Government approved 31 packages of medical care, this year 35 packages of the National Health Insurance Fund have already been approved. These medical care packages are formed by areas and provide primary, emergency, specialized and highly specialized, palliative care and medical rehabilitation. The program of medical guarantees is constantly updated - last year, for example, a separate package for the treatment of Kovid appeared. That is, thanks to funding, the National Health Service pays for specific medical services: a person applies to any medical institution for treatment, the institution reports, and the National Health Service pays for medical services at rates that provide medical treatment. means and medical devices. It is clear that gradually the program will expand, improve, the number of health care providers will increase. After all, private institutions, private individuals and additional state institutions will gradually join the Medical Guarantee Program.
If we turn to the figures, the expenditures on medicine, namely the Medical Guarantees Program, have increased by UAH 50 billion compared to 2019 - by almost 70%. And compared to 2020, they increased by UAH 36 billion, ie by almost 40%. All that remains is for health care facilities to use them effectively so that people can truly feel the infusion of these funds into medicine and state support. All of us, ordinary citizens, want to come to the hospital and receive quality free medical care, as defined by the Constitution of Ukraine. However, we understand that this is not an isolated fact when a person comes to the hospital and at the same time pays money for certain services. But it is the medical reform aimed at reducing the number of such cases, because the state must take on responsibilities and gradually,
Roman Volodymyrovych, the field of organ transplantation is currently actively developing in Ukraine: the Cabinet of Ministers established the Ukrainian Transplant Coordination Center, and the Ministry of Health paid for the first transplant operations. Will this area continue to be funded? To what extent and on what principle?
In previous years, hundreds of millions of hryvnias were earmarked for treatment abroad, that is, we transported people to other countries for transplants, where we performed operations. It was very expensive and caused great stress to patients and their families. But we understood that in Ukraine there are also specialists in the field of transplantation who can perform such operations, and therefore, our task is to resolve this issue at the legislative level. In 2018, for the first time, the state budget allocated 112 funds for operationsmillion hryvnias. It was during this period that our first meetings on transplantation took place, as well as the first changes in the legislation that allowed transplantation from a non-family donor. And at the end of 2019, a number of significant changes were made to the law, and the Ministry of Health launched a pilot project, which was joined by 12 medical institutions in Ukraine: the Ukrainian Transplant Coordination Center was established, hospitals received a license and funding for 2020.
Currently, the number of transplant facilities has increased to 38.
This year’s budget already provides for 502 million hryvnias for transplant surgeries, including aeromedicine. This refers to the use of air transport in the development of transplantation, namely the air transport of anatomical materials, in particular the transport of the donor heart within a certain time.
That is, the system is improving, the number of specialists is growing, and the money remains in Ukraine, which can not but motivate us all to develop this area and help our citizens in the future.
Author Ksenia Annyuk
Photo by Mar and I Duka
Read also: Boarding school with the soul: memories, revelations and inspiration of the director COLLECTED
"Today, the state is making every effort to increase funding and provide citizens with quality medical services,"- Roman Yermolychev, Deputy Minister of Finance of Ukraine.
Roman Volodymyrovych, tell us, how and to what extent in 2021 is the state funding of compensation for hearing loss in children?
First of all, I would like to draw your attention to the fact that in 2021 the funding of hearing loss compensation was continued, because in fact a comprehensive solution to this problem began in 2018, when the Ministry of Finance initiated care in this area. A few years ago, there was a great need for these specialized medical services, because the state funds for hearing aids were not provided by the budget, while the queue for the operation was about 400-450 people. If we add to the problem of lack of funding well-founded medical recommendations on the need for timely compensation for hearing loss in children (for example, the deadline for medical intervention, including rehabilitation of the child and successful social adaptation - up to 5 years) ... the need needs to be addressed at the state level as soon as possible. It is clear that not everything worked out at once: for several years we cooperated with the National Academy of Medical Sciences of Ukraine and the Institute of Otolaryngology. prof. OS Kolomiychenko National Academy of Medical Sciences of Ukraine. Almost every week, representatives of the Ministry of Finance held meetings to resolve current issues with specialists in the field, and finally, together, we have established this process in Ukraine. It is worth noting that the 2021 budget provides 360 million hryvnias of state funds for implantation hearing aids for children and adults who are in line.
That is, the funding program also covers citizens over the age of 18?
For the past two years, funding for hearing loss compensation has been closed for both children and adults. The price of cochlear implants, which stimulate the fibers of the auditory nerve with electrical impulses, is quite high - one device costs about 750 thousand hryvnias; a speech processor that transmits impulses (sounds) directly to the cochlear implant costs 285,000 hryvnias. We understand that for people these are unaffordable sums, and therefore, the task of the state is to provide financial assistance to its citizens. In 2021 alone, 58 children and 21 adults were operated on, as well as additional speech processors for the cochlear implant system for 35 children and 7 adults. And if we talk about the queue, it currently consists of 56 children and 80 adults for cochlear implantation and 41 children and 5 adults for speech processors. Comparing the figures that were a few years ago, it is no longer 450 people. But it should also be noted that the queue is formed not because the Ministry of Finance can not provide "instant" funding for hearing aids for all at once, but because according to medical indications, the person in the queue needs a thorough diagnosis. Therefore, doctors need about six months to collect a medical history, examine the patient, check whether the implant will take root and only then operate.
It is clear that charitable foundations are still involved in hearing aids. However, a few years ago, almost all funding was in the area of responsibility of philanthropists and philanthropists. To date, this issue has been resolved by the Government, and charities can now focus more on other areas of assistance.
What are the current prospects for public funding for cardiology in Ukraine? It should be noted that in April 2020, Ukraine began to reform the secondary care: secondary hospitals provide more specialized services, including in the field of cardiology, and the cost of these services, if they are part of the Medical Guarantee Program - free of charge for the patient . The Medical Guarantees Program includes municipal medical institutions that cover the needs of medical care in the field of cardiology in the regions.
In addition, there are 4 state institutions of cardiology of the Ministry of Health and the National Academy of Medical Sciences of Ukraine, namely: Institute of Heart of the Ministry of Health of Ukraine, Scientific and Practical Medical Center of Pediatric Cardiology and Cardiac Surgery of the Ministry of Health of Ukraine, Institute of Cardiology MD Strazheska and National Institute of Cardiovascular Surgery. MM Amosov National Academy of Medical Sciences of Ukraine.
For example, in the case of such institutions of medical sciences as the Institute of Cardiology named after Academician MD Strazhesk and the National Institute of Cardiovascular Surgery. MM Amosov NAMS - for them in the budget of 2021 provided 306 million hryvnias, and 130 million hryvnias, this year allocated for updating the material and technical base of these institutions. If we talk about the average cost of the service provided by these institutions, it is about 100 thousand hryvnias. I emphasize that the state clearly pays these funds at the rate of the above-mentioned institutions. Imagine a person coming to the Institute. MM Amosov or Institute. MD Strazheska on referral (this is a standard procedure in medicine), and in this case the state covers the cost of treatment.
What about other areas? What other areas does the Medical Guarantee Program cover?
Last year, the Government approved 31 packages of medical care, this year 35 packages of the National Health Insurance Fund have already been approved. These medical care packages are formed by areas and provide primary, emergency, specialized and highly specialized, palliative care and medical rehabilitation. The program of medical guarantees is constantly updated - last year, for example, a separate package for the treatment of Kovid appeared. That is, thanks to funding, the National Health Service pays for specific medical services: a person applies to any medical institution for treatment, the institution reports, and the National Health Service pays for medical services at rates that provide medical treatment. means and medical devices. It is clear that gradually the program will expand, improve, the number of health care providers will increase. After all, private institutions, private individuals and additional state institutions will gradually join the Medical Guarantee Program.
If we turn to the figures, the expenditures on medicine, namely the Medical Guarantees Program, have increased by UAH 50 billion compared to 2019 - by almost 70%. And compared to 2020, they increased by UAH 36 billion, ie by almost 40%. All that remains is for health care facilities to use them effectively so that people can truly feel the infusion of these funds into medicine and state support. All of us, ordinary citizens, want to come to the hospital and receive quality free medical care, as defined by the Constitution of Ukraine. However, we understand that this is not an isolated fact when a person comes to the hospital and at the same time pays money for certain services. But it is the medical reform aimed at reducing the number of such cases, because the state must take on responsibilities and gradually,
Roman Volodymyrovych, the field of organ transplantation is currently actively developing in Ukraine: the Cabinet of Ministers established the Ukrainian Transplant Coordination Center, and the Ministry of Health paid for the first transplant operations. Will this area continue to be funded? To what extent and on what principle?
In previous years, hundreds of millions of hryvnias were earmarked for treatment abroad, that is, we transported people to other countries for transplants, where we performed operations. It was very expensive and caused great stress to patients and their families. But we understood that in Ukraine there are also specialists in the field of transplantation who can perform such operations, and therefore, our task is to resolve this issue at the legislative level. In 2018, for the first time, the state budget allocated 112 funds for operationsmillion hryvnias. It was during this period that our first meetings on transplantation took place, as well as the first changes in the legislation that allowed transplantation from a non-family donor. And at the end of 2019, a number of significant changes were made to the law, and the Ministry of Health launched a pilot project, which was joined by 12 medical institutions in Ukraine: the Ukrainian Transplant Coordination Center was established, hospitals received a license and funding for 2020.
Currently, the number of transplant facilities has increased to 38.
This year’s budget already provides for 502 million hryvnias for transplant surgeries, including aeromedicine. This refers to the use of air transport in the development of transplantation, namely the air transport of anatomical materials, in particular the transport of the donor heart within a certain time.
That is, the system is improving, the number of specialists is growing, and the money remains in Ukraine, which can not but motivate us all to develop this area and help our citizens in the future.
Author Ksenia Annyuk
Photo by Mar and I Duka
Read also: Boarding school with the soul: memories, revelations and inspiration of the director COLLECTED