The issue focuses on the health care system as a key element of the structure of the sustainable development economy. The first stage of the study was to determine the factors and initial conditions for building an effective health care system in Ukraine. It is argued that the initial conditions for building the effective health care system in countries vary widely and are characterized by varying strengths of challenges and threats. It is concluded that Ukraine’s economic development is largely determined by global determinants along with national ones, among them the most influential are: capital, success and effectiveness of structural reforms, effective changes in industrial policy, transformations in public consumption, investment-innovation and technological policy, institutional development infrastructure of small and medium business. The systemic problems of the domestic economy and the health care system have been identified. The planned financing of health care elements for 2021 has been analyzed and its weaknesses have been identified. Emphasis is placed on the contradictions between the priorities of the state budget and its coverage. The problem of potential sources of expansion of general expenses is considered. The basic elements that are necessary for the development of the health care system of Ukraine in modern conditions have been identified. The content of economic, ecological and social components of the transformation of the health care system, which are realized through the active participation of the state, private sector and society in the development of the medical sphere of the country, is revealed. The environmental component in the aspect of health care is revealed through crisis determinants that qualitatively change the indicators of health system efficiency. A set of determinants of health care functioning on a global scale is described, among which economic, political, ecological threats, educational crisis; threats of global terrorism are singled out. The basic requirements to the health care system are defined and substantiated on the basis of the analysis of the health care market of Ukraine, the analysis of the purposes of the health care system functioning and the purposes of sustainable development in Ukraine. The content of the basic requirements for the health care system, which corresponds to the formulated basic principles of the effective health care system, is revealed. The priorities for formulating the requirements for the health care system in the conditions of sustainable development of economic relations have been formulated.