Abstract
BACKGROUND. In 2013 Ukraine ranks 78 place according to UN Human Development Index scoring. While education HDI components take the country forward, life expectancy at birth, in contrary, takes it backwards. The latter is due to violation of the constitutional right of Ukrainian citizens on equal access to health care. GOAL. To analyze the main reason of this situation – stream widespread of the informal payments for medical care and shadow health economics as a whole. MATERIAL AND METHODS. UN, State Statistics Service and National Bank of Ukraine statistical data. RESULTS. Provision of medical services in the state health care in exchange for payments by patients (informal economics or gray market) is a part of the shadow economics in Ukraine. Its external causes – monopoly of the multinational pharmaceutical corporations in the world economy, their pressure on the national market and behavior of physicians, globalization and offshore. Internal reasons – use of public resources for big business purposes, high rate of shadow schemes in national economy and health system, low level of health financing and salaries of medical workers. Informal health economics entails significant costs: productive – used public resources and time for private goals of physicians; transaction – increases the asymmetry of information about the quality of medical care, social – forms in the public sector quasiprivate market for medical services with all its negative externalities. СONCLUSIONS. In order to reduce informal health economics in Ukraine it is necessary to: abandon the oligarchic model of the national economy, improve the tender legislation and eliminate corruption in the purchase of medicines and equipment, substantially increase health care financing and restructuring, create an independent judicial system for protecting patients’ rights, introduce compulsory social health insurance, support non-profit medical associations. Keywords: shadow economics, informal health economics, “gray market, health care financing.
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