Interaction between health insurance, household income, and public health financing in Ukraine

  • Received August 25, 2022;
    Accepted November 21, 2022;
    Published December 14, 2022
  • Author(s)
  • DOI
    http://dx.doi.org/10.21511/ppm.20(4).2022.33
  • Article Info
    Volume 20 2022, Issue #4, pp. 436-450
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This work is licensed under a Creative Commons Attribution 4.0 International License

The most significant problems in financing the public health system in Ukraine are the permanent deficit of public spending on medicine and the shallow development of the voluntary health insurance market. The aim of study is the search of optimal interactions between stakeholders in the system of relations “state – insurance companies – households” in the context of voluntary health insurance. The study hypothesizes that households can become more active participants in health insurance only if their average monthly income reaches a certain threshold level. It is calculated based on the results of simulation games using the Brown-Robinson iterative method. According to the simulation results, this threshold level is only 7% higher than the actual value of the average monthly income of Ukrainian households during the analysis. At the same time, under this condition, the state in Ukraine will be able to transfer part of the financial burden of compensating healthcare costs to insurance companies. According to the calculations made with the help of the game theory toolkit, with the maximization of insurance payments to the population under health insurance contracts, the burden on public health financing in Ukraine could be reduced by 67.7%. The paper was conducted on the data of the ten most potent insurance companies of Ukraine as of 2021 (it is they who accumulate the lion’s share of household insurance premiums), that is, before the start of a full-scale war between the Russian Federation and Ukraine. The obtained results can be used both by insurance companies during the management of insurance premiums and payments and at the level of state management of costs in the field of public health.

Acknowledgment
This study was undertaken as a part of the research projects granted by the Ministry of Education and Science of Ukraine: “Socio-economic recovery after COVID-19: modeling the implications for macroeconomic stability, national security and local community resilience” (registration number 0122U000778); “The impact of COVID-19 on the transformation of the system of medical and social security of population: economic, financial-budgetary, institutional-political determinants” (0122U000781).

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    • Table 1. Key indicators of the top 10 insurance companies (as of 2021) for 2012–2021
    • Table 2. Descriptive statistics of the indicators
    • Table A1. Payment matrix of the game, where insurance companies and households are the players
    • Table В1. Fragment of iterative calculations to determine the optimal level of insurance premiums
    • Table С1. Payment matrix of the game, where the players are insurance companies and the state
    • Table D1. Fragment of iterative calculations to determine the optimal level of insurance payments
    • Conceptualization
      Aleksandra Kuzior, Dariusz Krawczyk
    • Project administration
      Aleksandra Kuzior, Dariusz Krawczyk
    • Validation
      Aleksandra Kuzior, Dariusz Krawczyk
    • Data curation
      Iryna Didenko, Natalia Sidelnyk
    • Formal Analysis
      Iryna Didenko, Natalia Sidelnyk
    • Visualization
      Iryna Didenko, Natalia Sidelnyk
    • Writing – original draft
      Iryna Didenko, Natalia Sidelnyk
    • Methodology
      Iryna Didenko, Tetiana Vasylieva
    • Supervision
      Natalia Sidelnyk, Tetiana Vasylieva
    • Writing – review & editing
      Natalia Sidelnyk, Tetiana Vasylieva