Медичне страхування під час воєнного стану в Україні: практичний нарис

Науковий керівник
Назва журналу
Назва тому
У статті проведено аналіз змін нормативної бази України, які забезпечують функціонування різних видів страхування у сфері охорони здоров’я. Висвітлено існуючі проблеми надання медичних послуг, пов’язані з російською агресією та введенням воєнного стану в Україні. Проаналізовано зміни в порядку надання медичної допомоги за договором добровільного страхування та в сфері обов’язкового солідарного медичного страхування за програмою медичних гарантій.
The organization of the healthcare sector in every country aims to provide the widest possible access to quality medical services for a broad range of citizens. A widespread practice globally is the involvement of citizens or potential patients through an insurance system. Changes initiated during the healthcare reform in 2017 have launched the development of insurance medicine processes. The fact of military invasion in Ukraine, stagnation in the country’s economic sector, and new needs in the field of medical services once again correlate with the vector of development of medical insurance and the functioning of the healthcare sector as a whole. The state of martial in Ukraine has altered the principles of the insurance system’s operation in the country and changed the provision of medical services for certain categories of citizens. The article provides an analysis of the changes in Ukraine’s regulatory framework that ensure the functioning of various types of health insurance in the healthcare sector. It highlights the existing problems with the provision of medical services related to Russian aggression and the imposition of martial law in Ukraine. The changes in the procedure for providing medical assistance under voluntary insurance contracts and in the field of mandatory solidarity health insurance under the medical guarantees program are analyzed. War is defined as a «force majeure», which is always stipulated in insurance contracts. This clause may be the basis for postponing the performance of an obligation without accruing penalties or fines, but it does not release from obligations under the contract. Insurance contracts remain in effect regardless of the state of war. War risks are not covered (except in cases of specific policies that exist but are very expensive and exceptional), and areas of military operations and temporarily occupied territories are excluded from the coverage zone. One of the problematic issues without a precise legal definition is the question of online medical consultation. The challenges of wartime create new types of relationships in the field of medical insurance, requiring a prompt response from the state and the preservation of the principles of universality, accessibility, and quality of medical services. The absence of a Law on Medical Insurance, a list of individuals who can be subject to mandatory medical insurance, and the absence of insurance for professional risks of medical workers, combined with the economic problems of the insurance market caused by the actions of the Russian Federation during the war, create new problems for private sector insurers. The share of insurance companies’ decreases and the National Health Service remains the main insurer. This article is the result of an analysis of the processes and mechanisms for providing medical services within the framework of voluntary and solidarity-based health insurance during wartime, as well as the changes that require a prompt response from the legal system.
Ключові слова
медичне страхування, надання медичних послуг, медичне обслуговування населення, медична допомога, договір добровільного медичного страхування, медична евакуація, medical insurance, medical service providers, medical care, medical insurance contract, medical evacuation
Бібліографічний опис
Правова держава = Сonstitutional State