Medicine needs state funding
“Medicine needs resuscitation,” “Doctors are also human,” “We are hungry” were among the slogans put up by white-smocked defenders of the nation’s health in front of Verkhovna Rada on July 12. There were also bullhorns and bright banners (sans portraits of proletarian leaders, as it were)... The most active front-rank pickets were bursting to lay their hearts on the line to journalists.
“I am a pediatrician in Pivdenny, Odesa oblast,” says Tetiana Ostapenko. “I earn 165 hryvnias a month, of which I spend 115 on public utilities. My child has to eat nothing but macaroni for breakfast, lunch, and dinner. I know, like nobody else, that children of this age need at least 200 gr. of meat a day. I look eagerly, like a hungry dog, into the hands of my little patients’ parents: what about a five or a ten?”
This kind of emotionality was not just another occasion to rail against a bitter destiny and draw attention to oneself. For as much as a third of the population might as well come out on the street (statistics say the “poor” and the “extremely poor” account for 25% and 12% of the population respectively). Yet, it is obviously doctors and nurses who are turning a blind eye to them. Even the far from richest teachers earn an average 345 hryvnias against the 256 for doctors. The latter had their seniority benefit abolished in 1991, while the health improvement allowance established by the cabinet has never been paid, although nurses and doctors work 38.5 hours a week.
Medical personnel are already contemplating a strike, to which they, incidentally, have no right under the law. Still, they have found an excuse: it is equally unlawful to ignore the demands of hired employees. The health care trade union, engaged in a labor dispute with the government since December 2001, demands that fixed salaries be raised at least step by step in 2002-2003. But, according to chairperson of the union’s Kyiv branch Larysa Kanarovska, the Ministry of Finance has answered in the negative, while other ministries have broadly hinted that all these efforts are futile.
It was expected that Verkhovna Rada would pass the law On Mandatory Social Medical Insurance in the third reading well before the parliamentary elections. Many experts are inclined to think that this law could be a realistic model of health care funding in this country. Meanwhile, the medicos have reached a deadlock: they demand a decent salary which the state is simply unable to pay. In addition, with hospitals and infirmaries having almost no legal opportunities to raise funds, budget expenses account, according to the Ministry of Public Health, for just a third of the funds required by the sector.
On the last day of the current parliamentary session, the protesters were joined by the Verkhovna Rada Committee for Social Policy and Labor, in a body headed by Vasyl Khara. The “medical” committee led by Mykola Polishchuk tried as best as it could to encourage colleagues. According to the committee, the cabinet has decided to raise medical personnel’s pay by 25% (i.e., by 30 hryvnias — Author ) from July 1, 2002. Moreover, a task force of people’s deputies and government officials will be formed by September to lobby for health care reforms. At the same time, Vasyl Khara (KPU) maintains a healthy skepticism about this, trying to prove his view with this year’s figures: the budget is being fulfilled worst of all in the medical sphere, where pay arrears are constantly rising (they rose by 10.8% in June —Author ). Mr. Khara called on medicos to “pressure” the cabinet and “their own” ministry. This is quite a strange stand for a politician. It is doubtful that creating a free- medicine myth and just pressing the government for funds will really help the medicos. Minister of Public Health Vitaly Moskalenko never appeared before the pickets, although his ministry is close by and the demonstrators were bursting to speak to him. He preferred to send Deputy State Secretary Anatoly Kartysh. Expressing the protesters his regret and sympathy, the latter stated that “Ukrainian industry practically does not work,” so it would be naive to dream about additional appropriations for medicine.
Incidentally, the ministry had tried to thwart the mass march toward the parliamentary walls. Mr. Moskalenko held peace talks with the Coordination Board of the medical union’s central committee, with the only result being the postponement of the protest action from June 27 to July 12. Moreover, longtime aggressiveness was further exacerbated by the latest Constitutional Court ruling on free medicine and its likely consequences for both doctors and patients. Incidentally, addressing the angry crowd of doctors and nurses, Serhiy Tyhypko, member of the parliamentary committee in question, repeatedly stressed that contributory sickness funds should be reestablished and insurance- based medicine introduced as soon as possible. He thinks this is the only way to solve the problem.
