Many nations are unhappy with their health care system, but these disputes don’t make me feel any better about the pitiful state of things in Ukraine. While I can’t do a deep analysis of it and offer solutions, I can share my observations as a user of the health care system in Ukraine.
The Soviet Union prided itself on all the free things it offered its citizens, including education and health care. Now that the U.S.S.R. is long dead, health care remains nominally “free.” This is an absurdity, since the Ukrainian medical sphere is practically broke. Polyclinics and hospitals have hardly any medicine or necessary materials. Every patient has to provide anything he may require, from sedatives and painkillers to bandages and syringes. Also, doctors working at state clinics in Ukraine make such miserable salaries that many of them will not treat you with any special care and inspiration – unless you make a “donation.”
And when it comes to some serious cases – like having an operation or giving birth to a baby, it’s in our best interest to pay. Also, the price goes up if you’re visiting a clinic to which you’re not assigned by place of registration in Ukraine. A friend of mine who gave birth recently paid Hr 500 directly to her doctor, plus an Hr 700 formal donation to the hospital, since she wasn’t registered in the area where the hospital was located.
The positive side of the Ukrainian health care system is that you don’t need to have expensive insurance to get an ambulance or have a doctor come to your home, make a diagnosis and write a prescription or a sick-leave certificate. On the other hand, if you don’t prepay your medical treatment, you can’t demand quality service. Some doctors are simply incompetent, whether because they bought their way though medical university or another reason. But they still have their jobs because of experience or connections.
My mom recently had an unpleasant experience in a state polyclinic. She arrived with a broken little toe and left with a heavy cast that covered her whole foot and ran up to her knee! Moreover, the cast was sloppily done. The toe wasn’t even fixed and kept giving her pain. After dragging the cast around the house for a couple of days, unable to do go out and do her business, she went to another doctor on a friend’s recommendation. That physician was shocked at the “treatment” she received. He threw away the cast, and simply tied the little toe to the one next to it. Thus my mom could continue with her everyday life, only being forced to abandon her favorite high-heeled shoes for awhile. The moral is: Don’t go to just any doctor in Ukraine. Ask around.
But even if you do go to a recommended doctor, he or she may not have the necessary medicine, forcing a trip to the drugstore. Also, in many clinics and hospitals, the equipment is old and outdated. Private clinics in Kyiv are more likely to have the latest equipment. But here is the catch. There is a common, and not completely groundless, fear that every doctor in such a clinic will do his or her best to prescribe you as many procedures as possible, to keep milking you for money until you run dry. It’s also true that getting treatments from such clinics is way more expensive then slipping modest bribes to your common state-employed doctor. A single consultation of a regular therapist at such a place may cost you more than Hr 200, and it’s easy to imagine how much the more complex and serious things will run you there.
Naturally, the wolf is never as scary as it is painted and private clinics differ. My recent experience with one of those proved positive. This one is not widely advertised, but has a steady flow of clientele. It is also located on the block that is full of state medical institutions, which helps earn trust.
I went through an overall medical checkup there. It did cost me a small fortune, but it had its many benefits. First of all, they offered a program which allowed doing most of the checkups in one day. Second of all, everybody was exceptionally nice and doing what they could to make me feel comfortable. If you have been to some really depressing Ukrainian hospitals with moody and even rude doctors, you know how much of a difference attitude can make. And third, I have never seen so much fancy equipment since I saw the “House MD” TV series. This is already worth the price. Plus there are no lines, and doctors keep to the schedule. The specialists I saw appeared to be professionals and I trusted their diagnosis. As for the “milking” strategy – it did feel like they were prescribing extra checkups and procedures a bit too leisurely. On the other hand, they didn’t pressure me.
In the end, we’re left with few options. One is getting medical insurance, which is still an unpopular practice here. Another is finding a good doctor and sticking with him or her. Having family dentists is common among Ukrainians, but you also need to form relationships with the right people in other medical spheres, too. Finally, if you can afford a private clinic – go with it. If not, go with the regular. Just make sure you’re dealing with a person you can trust, until much-needed reforms are undertaken, such as: require most people to pay and making free care available only to the truly poor; modernize hospitals and employ doctors who like their jobs and do them well – and get reasonable salaries for it.
Kyiv Post Lifestyle editor Alexandra Matoshko can be reached at [email protected].
