Logistic Support for Voluntary Social Health Insurance Subjects in Medical Legal Relations

Aim. To investigate the logistical support of voluntary social insurance among the subjects of medical legal relations who, in the course of performing professional duties as healthcare providers, do not always prioritize their own lives and health by neglecting to insure their own life and health. Additionally, consumers of such services may not be fully aware of the risks and the severity of the disease course, as well as the need for treatment. Materials and methods. In conducting an in-depth investigation into the implementation of voluntary social insurance among the subjects of medical legal relations, we conducted a survey of 500 individuals who are healthcare providers. The survey focused on the feasibility and necessity of introducing social insurance for the subjects of medical legal relations in healthcare institutions in the Kyiv region. As a result, a significant number of healthcare workers do not support the implementation of any type of insurance, primarily because it does not cover treatment costs (76%). About 14% express support for social insurance, but they are not fully informed about it. Additionally, 5% do not fully support any type of insurance, and 5% chose not to respond. Results. As of January 1, 2024, the number of insured individuals in the Social Insurance Fund of Ukraine was 3,236,285 (in 2023, this number was 4,436,584, indicating a decrease). Among them were 1,558,764 legal entities, 1,677,521 individuals, and 152 voluntarily insured individuals. An analysis of healthcare expenditures compared to European Union countries for the years 2019-2023 reveals that in the United States, 16.7% of the GDP is allocated to healthcare (with a GDP volume of $21.3 trillion USD), in Germany – 11.1% (GDP – $3.8 trillion USD), in Poland – 4.86% (GDP – $592 billion USD), in the Czech Republic – 7.4% (GDP – $414 billion USD), in the United Kingdom – 9.8% (GDP – $2,830 billion USD), and in Hungary – 7.4% (GDP – $161 billion USD). Conclusions. The main steps have been formulated to increase the legal awareness of the respective category and, accordingly, to enhance the role of both state social insurance and additional medical insurance in the process of providing and receiving medical services, including: 1) clear definition of medical services not covered by the program of medical guarantees, as well as other cases in which medical services can be provided to patients at the expense of individuals and legal entities; 2) development of pharmaceutical insurance. Pharmaceutical insurance provides reimbursement for expenses related to the purchase of medicines and/or medical products; 3) improvement of cooperation between participants in the systems of state financial guarantees for medical services and private insurers; 4) simplification of mechanisms for the introduction of additional medical insurance; 5) raising the level of public awareness.