Our health care system was hardly prepared for the ongoing pandemic. The hospital resources are crippling, and outrage among Ukrainians hit either by the death of a loved one from COVID-19, or the impossibility of getting proper medical treatment, is growing.
Nearly two-thirds — 64 percent — of Ukrainians are not satisfied with health care reform, and about the same number believes that the government needs to drastically change the way it has been undertaken. The health and wellbeing of Ukrainians are of the highest value and so we need to act now and ensure they have access to the best healthcare services.
Private insurance and public-private partnerships that have proved to be successful globally could help us go out of the gridlock. The Ukrainian public overwhelmingly believes that medical treatment in Ukraine should be partly paid and partly free which justifies the rationale for the introduction of concessions in health care.
Although the concept of concession as such isn’t new in Ukraine, it doesn’t allow to attract private investments in the health sector. No medical facilities were transferred through concession last year, and all because the current procedure is extremely complex, bureaucratic and non-transparent.
Killing bribes
The lack of market mechanisms entices corruption that overburdens patients and erodes trust in the system overall. In most public hospitals, patients are still expected to bribe their way to proper services.
Furthermore, the network of health care facilities is outdated and does not sufficiently leverage modern technology primarily because of the lack of funding. Many Ukrainian hospitals are neither patient nor medical staff-friendly. For doctors to be able to perform their duties and save lives, they need to be provided with the best possible facilities, and public-private partnerships will effectively solve this problem.
3o-year concessions
We at the Office of Simple Solutions & Results propose to introduce a simple and transparent concession procedure for medical institutions that would be conducted through online auctions as opposed to shady schemes. The object of the concession may be one or several healthcare institutions performing the functions of multi-specialty hospitals for intensive treatment.
The concession period will be 30 years and concessionaires will be obliged to make significant improvements to the concession object within the first year and a half after winning a tender.
Additionally, concessionaires will also be responsible for providing free healthcare services for patients (not less than 80 percent compared to the year previous to that in which concession took place) that are provided by the concession objects.
To preserve jobs, after the reform, concessionaires will have to keep the hospital staff and increase their salaries. The societal benefits will be enormous. Under public-private partnerships, hospitals will be returned to the national property after the concession expires.
Global trend
Concessions in health care are widely used globally. The concessionaires will need to invest the amount of Hr 2 million per bed in the hospital which is twice more than the estimated cost of designing a bed in a modern hospital. According to the Ministry of Regional Development, that is Hr 820,000. That will allow us to improve the quality of hospital facilities.
Concessions will allow us to have modern well-equipped hospitals that do not have shortages of medicines. The quality of services provided will also improve, and it will be possible to receive additional medical services legally for an additional fee. We should ensure that the supply matches the Ukrainian patients’ demand.
We have been working on this reform for a long time and recently we had the opportunity to present the above-explained concept to the chairman of the Verkhovna Rada Committee on National Health, Medical Care, and Medical Insurance Mykhailo Radutsky. I look forward to working more closely with Ukrainian parliamentarians on bringing this reform to life.
Mikheil Saakashvili has been the chair of the executive committee of the National Reforms Council since May 7, 2020. He served as governor of Odesa Oblast from May 30, 2015, to Nov. 9, 2016. He was president of Georgia from Jan. 25, 2004, to Nov. 17, 2013.
