The influence of health insurance on coverage of a country’s population with medical services

In Ukraine, there is a steady increase in the mortality rate of the population, which is due to the low quality of medical provision. The main advantages and the efficiency factor of the health care system in the Western European countries are analyzed; the key factors regulating medical provision in Ukraine are systematized; the effectiveness of modern health care reform in Ukraine is evaluated; practical recommendations to improve the administrative and legal regulation of the system are developed. The analysis showed that the effectiveness of health care reform in Ukraine is currently about 30%, and the high mortality rate of the population in Ukraine is primarily due to the low quality of medical care and inadequate investment in the industry. The main health problems in Ukraine are failure to comply with legislation on the amount of funding and remuneration in the public health system, high levels of corruption and lack of control over the competence of doctors, inaccessibility of medical products for consumers due to the pharmaceutical market monopolization.

This study aims to conduct a comparative analysis of the SDG in healthcare achievement in Austria and Ukraine and to determine possible lessons for Ukraine based on best EU and world experiences. To identify existing challenges and perspectives a comparative analysis of key indicators of healthcare expenditures and health financing systems in Austria and Ukraine was carried out. Results indicate that in Ukraine there is a substantial lack of public funding for healthcare (only 682 US dollars per capita in 2018), a poor share of voluntary health insurance (less than 1%), significant amounts (on average 50%) of expenditures of the population in general spending on health. On the contrary, in Austria, there is sufficient public funding for healthcare (5,879 US dollars per capita in 2018), more than 5% share of voluntary health insurance, moderate amounts (on average 25%) of expenditures of the population in general spending on health. Austria’s experience as an EU-member country with a successful example of a financing strategy for the healthcare system is a sound example for Ukraine. The alternative financing tools (e.g. result-based financing, impact investment, public-private partnership) can be used as an additional financing mechanism of healthcare funding in Ukraine. The use of these instruments along with the improvement of the fiscal policy, social security, and governance based on Austrian experience can cut the existing financing gap to achieve SDG targets in healthcare in Ukraine.

Acknowledgment
This study is financed equally by the Austrian Federal Ministry of Education and Science and the Ministry of Education and Science of Ukraine.

Devastating effects of the COVID-19 pandemic throughout the world enhance the societal requests for effective healthcare and social protection systems, modern education, and high-quality infrastructure. In Ukraine, education, healthcare, and social services have been chronically deteriorating, and the corona-crisis has further exacerbated their state and increased poverty in the country. The aim of this study is to reveal the main weaknesses of fiscal policy in Ukraine and to outline the prospects of public finance transformations under the impact of the COVID-19. To achieve this aim, the indicators of fiscal policy response to the pandemic in Ukraine are calculated and a comparative analysis of Ukraine’s public finance structure with the international patterns is undertaken. A moderate fiscal impulse and insufficient fiscal rescue package in Ukraine are shown. Moreover, the inconsistencies of anti-crisis fiscal policy instruments with the international best practice are revealed. Summarizing the available theoretical sources and recent applied research allows identifying the prospects of public finances transformations under the impact of the COVID-19 in a global context. Along with the obtained results of Ukraine’s fiscal sector analysis, these form the basis for shaping the fiscal policy response in Ukraine over the medium term. Proposals for public financing of Ukraine’s health care and educational sectors, of the social safety nets and infrastructures under the impact of the pandemic are developed. Offsetting measures from the expenditure and revenue sides of the budget are drawn up for closing the arising fiscal gaps.