Huzela I., Doctor of Philosophy, Associate Professor of the Department of Finance named after S. I. Yuriy, West Ukrainian National University, Ternopil, Ukraine

ORCID: 0009-0008-2274-8788
e-mail: huzela1996@ukr.net

Health insurance models in foreign countries and directions of their implementation in Ukraine

Abstract. Introduction. Health insurance is an important mechanism for financial support of health care and social protection of the population. In foreign countries, various models of its organization and financing have been formed, differing in the role of the state, employers, insurance organizations and citizens.

For Ukraine, the search for the optimal combination of state, insurance and private financing, taking into account national conditions, is relevant. At the same time, direct borrowing of foreign experience is inappropriate, since the effectiveness of individual models depends on the socio-economic and institutional characteristics of the state. Therefore, it is important to determine the advantages and disadvantages of foreign models and justify the possibilities of implementing their individual elements in Ukraine.

Purpose is to study foreign models of health insurance, determine the features of their organization and financing, and also substantiate the possibilities of implementation individual elements of these models to the conditions of Ukraine.

Results. As a result of the study, the main models of health insurance in foreign countries: Bismarck, Beveridge, national and private were analyzed and the features of their financing, organization of medical care and the role of the state were determined. The advantages and disadvantages of each model were established and the inexpediency of their direct transfer to Ukrainian conditions was substantiated. The most appropriate elements of foreign experience for implementation in Ukraine were determined, in particular, solidarity insurance, employer participation in financing, state guarantees of basic medical care, centralized procurement of medical services and the development of voluntary medical insurance. The feasibility of forming a mixed model of health insurance that would combine state financing and guarantees, insurance mechanisms and the capabilities of the private sector was substantiated. It was established that the phased implementation of these elements, taking into account the socio-economic and institutional conditions of Ukraine, can contribute to increasing the accessibility of medical care, diversifying the sources of its financing and strengthening the financial sustainability of the health care system.

Conclusions. The study showed that foreign models of health insurance have different mechanisms for financing and organizing medical care, and their effectiveness depends on the socio-economic and institutional conditions of a particular state. Therefore, it is inappropriate for Ukraine to directly introduce any individual model.

The most reasonable approach is to form a mixed approach that will combine state financing and guarantees, solidarity insurance mechanisms, employer participation and the possibility of voluntary health insurance. At the same time, the adaptation of foreign experience should be carried out gradually, taking into account the financial capabilities of the state, the population and employers.

The proposed approach can contribute to the diversification of sources of health care financing, increasing the availability of medical services, strengthening the financial sustainability of the system and strengthening social protection of the population.

Keywords: health insurance, health care financing models, foreign experience, social insurance, state financing, voluntary health insurance, accessibility of medical care, financial sustainability, implementation of foreign experience.

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