THE LAW PRINCIPLES OF CONTRACTING ECONOMY IN HEALTH CARE OF UKRAINE

Author
, professor, Kharkiv, Pushinska, 77
, associate professor, Irpin, Universitetskaya, 31

In heading

 Economic theory of law;

Signed print

 25.11.2016

Issues number

 2016 - № 4 (27)

Page

 57-66

Type of articles

 Scientific article

Code UDK

 33:614:347.44 (477)

ISSN print

 2411-5584

Abstract

 Problem setting. The Constitution of Ukraine states that a human life and health are recognized as the highest social value. The mechanism of effective implementation of this rule is still imperfect. One of the urgent tasks is the introduction of contractual regulation of health service provision, combining the benefits of state and market.
Recent research and publication analysis. Typically, scientists of the different disciplines consider the problems of contracting economy, and also public- private partnership separately. But in practice they are intertwined. Therefore, researchers have the task to combine the approaches for modeling the optimal interaction of all participants of the health market.
Paper objective is to analyse the economic and legal frameworks of public-private partnership in Ukrainian health market, and offering the recommendations for improving contractual relations among all participants of the health services.
Paper main body. Historically negotiated economy is qualitatively new stage of development of the market economy. In health care it provides a participation of government as customer and purchaser of the goods and health services. Contracts are also concluded with third parties for the construction of public hospitals or other social projects. The contract provides the legal form of the mutual consent of its members, combining the benefits of state and market regulation of health care. Contracting economy, on the one hand, is a form of state regulation of the economy, and on the other hand, the kind of
public-private partnerships. The choice of private partners of the state is competitive, and areas where the partnership is used, adopted by law. Private partners provide greater efficiency and effectiveness than in terms of health care public hospitals.
Ukraine has a rather complicated and expensive procedure conclusion of contract, generating high transaction and opportunity costs. The law does not provide a clear list of grounds for rejection of this partnership for private investors and not offers him an efficient help. Often one-off projects are accepted created by the political will of local councils. Unlike the developed countries, dominated by socially important projects, Ukrainian legislation also covers other projects. The government of Ukraine not rush to attract the private partners, including foreign ones, in health care. The most patients have no legal protection guaranteed choice of doctor. A fair competition among physicians is absent, wage system is an outdated, which ultimately reduces the quality of medical services and spur the development of contractual relations among health care providers or doctors, the private partner and the patient. Instead, unfair competition is developing for shadow, informal income.
Conclusions of the research. Contracting economy in health care is an integral part of a mixed economic system that is based on the legal, social state. Our recommendation: amend legislation by terms which reinforce the specific public-private partnerships in health care and fix allocation of risks and responsibilities among partners; singled out for this the healthcare segments, the list of major private partners, including employers and their associations; make at macro level and implement the approximate and standard contracts for medical services. Further development of economy and law provides research on the role of insurance companies and employers’ associations in the development of the contractual economy, their impact on increasing the competitiveness of health services; implementation of the voucher system of choice of medical institutions and doctors by patients.
Short Abstract for an article
Аbstract. This paper analyzes the legal possibilities of the contractual economy and implementation of public-private partnership in the health system. It reveals the potential opportunities of the state, medical institutions and private partners in the development of this industry, with its focus on the social impact. It’s suggested the need to involve in the status of private partners the employers and state as guarantor of constitutional rights of citizens and controlling entity. The work is accompanied by proposals for amendments to the Basics Ukrainian legislation on health care and the Law of Ukraine «On public-private partnership».

Keywords

 Public-private partnership, contractual economy, health, employers, health institutions.

Reviewer

External reviewer

Article in PDF

 4 57-66

Bibliography

 none

Code DOI

This post is also available in: Ukrainian

19.10.2016