Іноземна мова

          All times it was considered, that medical aid must to be available and qualified.

          Medicine-it is not only important branch of human activity, but also vitally necessary. In the whole world this is well understanded, but in the postsoviet space the approach remains almost unchanging. The world achievements of modern medicine are huge, openings  are stunning, but to say that Ukrainian medicine experiences the not best times should meant to adorn a situation. A general crisis in society was reflected on the health of ordinary citizens. One of the reasons is nominal «free of charge» of our medicine.            Gradually we got used to all, even to that in hospital it is needed to go with its bed-clothes, not speaking about the bag of medicine, syringes and etc And from list, which is presented to the patient during the hospitalization, becomes не пособі  sometimes.

          Today a budgetary expenditures on the health protection make only 3% internal gross output, that is one third of necessary minimum. Then, when in Europe the budgetary assignations on the health protection make at least 6% IGO. A necessity of medicine in Ukraine today makes a 35-40 billion of grn, but really we have a 12 billion of grn, that is level of charges is less than 30% from necessity, and more than 80% from the amount of budgetary medical monies are not expended on patient. It expended on maintenance of branch. From the budgetary facilities, that are selected to Ukrainian medicine, 70% «eats» a salary, communal payments - 20%, and on medicines and equipment - all, that remained, that is tears. It is paradoxically, but from 2001 to a 2005 year financing of medicine grew twice and made in 2005р.- a 11, 6 billion of grn. Did feel this on itself ordinary citizens? No! By what to explain this nonsense? In spit of  increasing of financing, the Ukrainian system of health protection remains or by one of the branch, which were least touched the market transformations. In the level of financing of health protection we are on a 120 place in the world, but in quality of grant of services we are on the 60 step. In 2006 on the medical service of one citizen of Ukraine would selected nearly 236 grn, that is almost on a 100 grn more than in 2005. For comparison: in the USA this sum makes 2500 dollars.

          In spite of «free of charge»? of Ukrainian medicine, which is declared by Constitution the payment of medicine aid regularly is carried out by more than 70% patients. Knowing about the deplorable state of the system of health protection, we try to «ward» off the not quality medical treatment, trying to take advantage of traditions of payment of medical services - in envelope, in the box or in bottle.

          And how to be with the constitutionally vested right of citizens on the free of charge medicine?

          For today there is nothing legal act, which legislatively secured functioning of the integral system of health protection in its structural, financial and skilled providing. However and acceptance of new bills, and also bringing of amendments and supplements to the before accepted laws, which are concerned of the system of health protection, can remain impracticable, there will if not be expressly definite the correspondence between a 49 item of Constitution, which indicates on free of charge of medicine, and item 95, in which it is marked, that «.exclusively by a law about the State budget of Ukraine determine any charges of state on the common social necessities, size and purpose direction of these charges». How see an item 49 and 95 of Constitution of Ukraine except each other.

          Constitutional Court of Ukraine considered a case about the official interpretation of position of part 3 of item 49 of Constitution of Ukraine. «In the state and communal establishments of health protection the medicine is given  freе of charge.»

          Exploring materials of case, Constitutional Court of Ukraine came to such conclusions:

-    term «freе of charge» in combination of words the «medicine aid is given freе of charge» means that an individual, which gets such help in the state and communal establishments of health protection, must compensate its cost neither as any payments, no in any form regardless of time of grant of medicine aid.

         The decision of Cabinet of Ministers from 11.07.2002 gives a list of types of free of charge of medicine aid, this is:

-    rapid and exigent;

-    ambulatory-policlinic;

-    stationary;

-    stomatology helping in the complete volume;

-    before hospital medicine aid  to the peasantry;

-    sanatorium-health resort help to the invalids and patients in the specialized and child's sanatoriums;

-    dependent of children in the houses of child;

-    medico-socialy examination of loss of capacity.

         The state must guarantee a definite volume of medical services, for which a man must not pay. However  nothin budget can not to secure a free of charge of medical services fully.

Therefore the state must to search the additional sources of financing of medicine. Only this will help to reorganize a health protection. The way for this is introduction of general obligatory state medical insurance. In the developed countries of world social-medical problems a long time ago left off to be problems. In relation to services, there is medical insurance.  Man, regardless of that, sick it or not, pays a definite sum monthly, as insurance payment. However, if a disaster will happen, complete medical help without any additional charges will be given to this men. In the case of illness insured addresses to insurance company. Insurance compani in its turn transfers in hospital a money for the operation, medications, meal and others like that. Patient takes a cure, its relatives are quiet, and it is not necessary to hurry, to search a money, medications. This is -  anxieties of insurers. Insurers will carry out the control on quality of grant of medicare.

         Of course,  the introduction of law «About the obligatory state medical insurance» at once will not give the noticeable changes. In Russia, for example, a law about the obligatory medical insurance is accepted in 1991. More than ten years passed, before he began to work and today 90% Russians are overcame by the system of obligatory medical insurance. However experience of countries of European Alliance with the socially oriented market economy testifies that financing of the system of health protection, in the basis of which a model of obligatory medical insurance is put, secures both high quality of grant of medical services, and the proper level of observance of social guarantees in the branch of health protection.

         So, a question about free of charge of medicine aid in Ukraine is very problem. But it needs the immediate decision, because taking into consideration that the real state of Ukrainian medicine, we can  speak about that is violated not only right on free of charge of Ukrainian medicine. Speech goes about the norm of Constitution, which proclaims the life  and health of man the greatest social value. The optimum decision of this problem exists  and it is used in the whole world during a long time. This is medical insurance. Then the interests of patient will go out on the first plan, that is a guarantee of high-quality service. Later we would speak about the improvement of material and technical state of medicine and about the improvement of material state of medical workers. Medical insurance is an economic category, which will impel to competition of both insurers, and doctors and will become motive force of development of medicine.