Abstract
Purpose. The purpose of the article is to analyse the state of the system of financing health care in the European Union countries and Ukraine, to identify and compare their efficiency. To achieve this purpose, the following tasks were set: to analyse the current state of the system of financing health care in the European Union using up-to-date statistics on health care expenditures; to analyse the state of the system of financing health care in Ukraine for the last five years based on statistical data on expenditures of the Consolidated Budget of Ukraine; to consider what needs the health care sector directs expenditures to; to identify the problems that were prompted medical reform in Ukraine; to identify and compare the efficiency of financing the health care system of the European Union countries and Ukraine. Methodology. During the preparation of the article, the author used the method of analysis and synthesis to review statistical data that provided an opportunity to analyse the current state of the system of financing health care in the European Union countries and Ukraine; the method of comparison was used to determine the efficiency of the models of the system of financing health care in the countries of the European Union, in order to further form useful advice for use in Ukraine during the period of medical reform; generalization method was used to summarize the results of the study. Results. Analysing the state of the system of financing health care among the European Union countries in 2019, it was found that the largest amount of health care expenditures was in Germany (the system of financing was based on the Bismarck model), and the smallest was in Latvia (the system of financing was based on the Beveridge model). Analysis of the dynamics of health care expenditures in Ukraine showed that over the past five years, the volume of expenditures has increased 2.33 times. In terms of the funds of the Consolidated Budget of Ukraine, the largest percentage (85-91%) falls on the expenditures of the general fund. In relation to the total expenditures of the Consolidated Budget of Ukraine, the share of health care expenditures in 2020 has amounted to 11.02%, which is 1.99% higher than in 2016. Despite the growing trend, the amount of budget expenditures is not enough for all the needs of the health sector. To identify the efficiency of the models of the systems of financing health care operating in the European Union countries and Ukraine, a comparison of the average life expectancy among the people of these countries was made. In the countries of Northern and Western Europe, there was the highest rate in the range of 81.1-83.1 years for both men and women; the lowest rate was observed in Ukraine (73 years). Ukraine is currently undergoing health care reform, which should change the Soviet model to one that will be closer to the English, which shows its efficiency on the example of European countries in the post-Soviet space. Practical implications. The results of the study can be used to form practical suggestions in preparation for the next stage of health care reform in Ukraine.
Highlights
The health of citizens has a significant impact on the economic development of the country, which directly depends on the state of financing health care
In accordance with the Concept and a number of adopted regulations, since 2018 Ukraine has started health care reform, which aims to introduce compulsory health insurance, in which the state acts as an insurer, and funding is based on the principle of “money follows the patient”
After the collapse of the USSR, Ukraine inherited a health care system based on the Semashko Model, i.e. financing health care from the state budget, at the expense of which citizens were provided with free medical care (Onyshko, Shevchuk, 2019)
Summary
The health of citizens has a significant impact on the economic development of the country, which directly depends on the state of financing health care. Three Seas Economic Journal are paid to private insurance funds in the way that one part is paid by employers as targeted contributions and the other part is paid independently by employees This model is used in Austria, Belgium, Italy, Estonia, Lithuania, Luxembourg, the Netherlands, Germany, Poland, Slovakia, Slovenia, Hungary, France, Sweden, the Czech Republic etc. This is due to economic differences between the countries of Northern and Western Europe, and the countries of Central and Eastern Europe, in terms of GDP, GNP, level of social security, wages, life expectancy etc. The average annual growth rate of health care expenditures per capita in 2019, compared to 2018, had a growing trend in all countries of the European Union (OECD/EU, 2020)
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