Propagandists are once again trying to spread panic among Ukrainians, claiming that soon all medical services will become paid. They assert that the Ukrainian authorities have already begun to take the first steps in this direction by introducing a fee for doctor appointments without a referral starting in 2025. They suggest that Ukrainians will have to pay for visits to the doctor, as scheduling an appointment with a specialist requires a lot of time and effort.
With the support of the USAID Health Reform Support project, VoxCheck analyzes and refutes public health narratives spread in the information space of Ukraine, Belarus, and russia on a weekly basis.
Information is being spread online that Ukraine has violated the article in its Constitution guaranteeing medical assistance. The post claims that the Cabinet of Ministers decided to “accustom” citizens to paid medical services from 2025 and to make doctor appointments without referrals paid. Additionally, they claim that making an appointment supposedly takes a lot of time.
What’s the reality?
The rule regarding paid appointments for patients without referrals has existed since the beginning of the reform in 2018. The resolution passed in July 2024 by the Cabinet of Ministers merely reaffirmed that such cases would not be covered by the Medical Guarantees Program. The document will take effect on January 1, 2025.
In 2017, the Verkhovna Rada passed the law “On Financial Guarantees for Medical Services”, which came into force in January 2018. This document provided for the creation of a list of medical services that the state would fully cover. This law is still in effect, and each year the Cabinet of Ministers determines the list of medical services that will be free for the population under the Medical Guarantees Program. Patients can receive these services at public, communal, or private medical institutions that have a contract with the National Health Service of Ukraine. In 2024, the Medical Guarantees Program includes 44 service packages, with nearly 3,600 medical institutions signing contracts with the National Health Service of Ukraine. More details about the free medical services available this year were covered in a previous issue.
At the same time, the law signed in 2017 established a list of services for which patients had to pay themselves, including non-urgent dental care for adults, aesthetic medicine, and visits to doctors without referrals. Family doctor Yurii Zinchuk, a member of the Kyiv Family Doctors Association, commented on this decision at the time: “People were given the opportunity to see a family doctor, choose their own doctor — this is a unique opportunity for a person to find a competent doctor they can trust… Now, those who have signed declarations with us, we will take care of them, these are our patients, they have entrusted us with their health. We will give all our knowledge, all our skills, all our experience… Those who have not signed a declaration will not be able to get a referral from a family doctor, they will go privately and pay a lot of money.”
Thus, the decision made by the government in July 2024 to charge for specialist visits without referrals merely reaffirms this rule. Additionally, the resolution clearly defines other services that patients have to pay for themselves. For instance, doctor appointments are chargeable under the following conditions:
- in medical institutions under contracts with legal entities;
- in medical institutions of the security and defense sector or the State Management of Affairs if patients are not attached to these institutions;
- not covered by the Medical Guarantees Program.
The Ministry of Health of Ukraine stated that the decision was made to combat informal payments. Medical institutions will be required to post a complete list of free services under the Medical Guarantees Program and a list of paid medical services with their prices on their websites and information boards. Therefore, the resolution does not violate the article of the Ukrainian Constitution guaranteeing access to medical care for all citizens. It does not limit the current number of free services but merely clearly defines paid services.
Additionally, the information claiming that making an appointment with a doctor takes a lot of time is not true. With a signed declaration, patients can book a free appointment with a family doctor at the medical institution’s registry or on websites (Helsi.me, Doc.ua, Medics, etc.), choosing a convenient time. This process takes a few minutes. Then, if necessary, the family doctor will provide an electronic referral to a specialist. If the doctor is on vacation or unavailable for other reasons, the medical institution must find a replacement, so patients can see another specialist even if they have not signed a declaration with the specified doctor.
For appointments with certain specialists and in specific cases, no referral is needed. The list of specialists who accept patients without referrals can be found in the infographic below.
Source: Ministry of Health of Ukraine
This information piece was produced with the assistance of the United States Agency for International Development (USAID), provided on behalf of the people of the United States of America. This article’s content, which does not necessarily reflect the views of USAID, the United States Government, is the sole responsibility of Deloitte Consulting under contract #72012118C00001.
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