Voluntary health insurance as a source of funding for the health care system: the world’s experience and Ukraine

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In the conditions of insufficient budgetary financing of the health care system and low quality of medical care in the state medical establishments of Ukraine, the importance of extra-budgetary sources of financing becomes increasingly relevant. One such source is voluntary health insurance. The aim of the paper is to compare the state and structure of medical financing in developed countries and in Ukraine, to study the global experience in the functioning of the voluntary health insurance market, and to calculate the potential capacity of the voluntary health insurance sector in Ukraine. For mathematical calculations, 20 absolute indicators of the state of the voluntary health insurance sector, as well as macroeconomic indicators, were used. The annual values of absolute indicators for the period 2010–2019 were used in forming the array of input data. Based on the experience of foreign countries, the paper substantiates the development of the voluntary health insurance in Ukraine as an extra-budgetary source of health care funding. The capacity of the voluntary health insurance sector was defined by the authors as the maximum possible amount of insurance premiums that insurers can receive in the process of selling voluntary health insurance products. The calculations made it possible to conclude that the voluntary health insurance market in Ukraine has the potential for development, as evidenced by the predominance of the potential capacity of the voluntary health insurance segment over its real indicator.

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    • Figure 1. Stages of capacity calculation for the voluntary health insurance sector
    • Figure 2. Average current health expenditures (2010–2017), % of GDP
    • Figure 3. Current health expenditure (% of GDP), Ukraine, 2010–2017
    • Figure 4. Average current health expenditure per capita (2010–2017), USD
    • Figure 5. Current health expenditure per capita in USD, Ukraine, 2010–2017
    • Figure 6. Average domestic general government health expenditure (2010–2017), % of GDP
    • Figure 7. Domestic general government health expenditure (% of GDP), Ukraine, 2010–2019
    • Figure 8. Structure of current health expenditure by financial resources
    • Figure 9. Structure of current health expenditure by financial resources, Ukraine, 2010–2017
    • Figure 10. Out-of-pocket expenditure (% of current health expenditure), Ukraine, 2010–2017
    • Figure 11. Structure of gross direct health premiums written on domestic market in Europe, %, 2018
    • Figure 12. The share of health insurance in gross insurance premiums, %
    • Figure 13. The share of health insurance in gross insurance premiums, Ukraine, %, 2010–2019
    • Figure 14. Determination of the type of growth curve for the volume of gross premiums of voluntary health insurance in Ukraine in 2010–2019
    • Figure 15. Real values of gross insurance premiums for voluntary health insurance in Ukraine and the values of this segment’s capacity in the period 2010–2019
    • Table 1. Interim calculations to determine the type of growth curve for the volume of gross premiums of the voluntary health insurance in Ukraine in 2010–2019
    • Table 2. Results of calculations of the adjustment factor and capacity of the segment of voluntary health insurance in Ukraine for the period 2010–2019
    • Table A1. Current health expenditure (% of GDP)
    • Table A2. Current health expenditure per capita (USD)
    • Table A3. General domestic government health expenditure (% of GDP)
    • Table A4. The share of health insurance in gross insurance premiums, %
    • Table B1. Data for the study of capacity of the voluntary health insurance sector
    • Table B2. The results of normalization of the study’s information base
    • Project administration
      Fedir Zhuravka
    • Supervision
      Fedir Zhuravka
    • Validation
      Fedir Zhuravka
    • Writing – review & editing
      Fedir Zhuravka
    • Conceptualization
      Olena Zhuravka, Eugenia Bondarenko
    • Formal Analysis
      Olena Zhuravka
    • Investigation
      Olena Zhuravka
    • Resources
      Olena Zhuravka
    • Writing – original draft
      Olena Zhuravka, Eugenia Bondarenko
    • Data curation
      Eugenia Bondarenko
    • Methodology
      Eugenia Bondarenko
    • Software
      Eugenia Bondarenko
    • Visualization
      Eugenia Bondarenko