ON THE ISSUE OF ALTERNATIVE MODELS OF MANDATORY HEALTH INSURANCE IN UKRAINE

Author

, professor, Kharkiv, Pushinska, 77
ORCID ID: 0000-0003-1359-834X

In heading

Economic theory;

Signed print

21.04.2017

Issues number

2017 - № 2 (29)

Page

14-24

Type of articles

Scientific article

Code UDK

330.1:364.3:61(477)

ISSN print

2411-5584

Abstract

Problem setting. Compulsory health insurance carries out a number of functions and has the significant advantages over purely budget health care. The lack of сompulsory health insurance in Ukraine is beneficial for the players of the shadow economy, from doctors to pharmaceutical companies and dishonest managers.
Recent research and publication analysis. The main point of scientific debate on improving the financing of public health in Ukraine are as follows: increase budgetary funding of industry, formalization of informal payments to doctors, the introduction of technologies in health care, the establishment of social insurance. Disputable issue is the determining of the seller of insurance services, which is manager of financial flow for health care.
Paper objective is to analyse the alternative models of сompulsory health insurance and offering the most optimal one for modern Ukraine, given the limited resources of health care.
Paper main body. Economic approach to choice of insurance model is comparison of the benefits and opportunity costs. The first model is only social mandatory health insurance that does not involve the private companies. The main regulator of insurance is the law. The advantages of this model are concentration of resources in a single national insurance fund, personal responsibility of top managers, the positive effect of scale and decreasing the average costs of production; reducing transaction costs from market imperfections.
Risks and opportunity costs associated with the state monopoly, bureaucracy and lack of market incentives of cost-effective activity in the industry. Competition among many providers of medical services for the single buyer often entail unfair competition and corruption.
The second model is involves a private company to compulsory health insurance and contracting with insured. Its advantages are the synergetic effect of process, increasing the total insurance money, use management practices that have accumulated insurance companies in the market, demonopolization of the insurance market and reducing of bureaucracy, the use of effective marketing strategies for the creation of new insurance products. The risks of this model are related with oligarchic economy of Ukraine. These include the pursuit of profit by players of the insurance market at any cost, benefits for those of them who are closer to the government and monopolize certain types of insurance, as well lack of transparent competition. There is a danger of offshore schemes and unfair reinsurance. In turn, modern insurance companies in Ukraine that sell policies of voluntary medical insurance, is still not ready to participate in the mandatory health insurance too.
The comparison of the opportunity costs in various models of the health insurance proves the need for intermediate one which optimal for a while.
Conclusions of the research. It is necessary to introduce only the сompulsory medical insurance, in which a source of health care financing are expenditures of the State Budget of Ukraine. Additional premiums of employers and workers on the payroll are dangerous because stimulate the shadow economy. The involvement of private insurance companies also have significant threats. In order to reduce the opportunity cost of the insurance model proposed, and enhance its benefits, it is necessary to form the elements of the market environment, promote competition in different directions, particularly among potential top managers. It is appropriate the use of management functions outsourcing if its benefits outweigh the risks, as it helps to improve drastically the efficiency of insurance and medical services.
Short Abstract for an article
Abstract. The article analyzes the alternative models of mandatory health insurance. It is proved the premature of accession the private insurance companies of Ukraine to it and introducing an additional tax on workers and employers. It is proposed the optimalnational model based on budget financing of the insurer.

Keywords

compulsory health insurance, insurance companies, benefits, opportunity cost, risk.

Reviewer

External reviewer

Article in PDF

2 14-24

Bibliography

none

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02.02.2017