Financing of the Public Health Services at the Level of Local Budgets

In conditions of reforming the health care system and budgetary decentralization in Ukraine, the important issue is the financing of the public health services at the level of local budgets. The purpose of the article is to analyze financing of health care system in Ukraine at the level of local budgets, to determine its problematic aspects and ways to improve. The dynamics and structure of expenses on public health services from the state and local budgets was estimated. It was revealed that most of the health facilities are fully or largely financed from local budgets, which is in line with the policy of budgetary decentralization, but they have insufficient funds to carry out a qualitative reform of their activities. The analysis of the dynamics and share of the medical subvention in all expenditures of local budgets on health care system has been carried out. The comparison of the volume of expenses on public health services and the volume of GDP has been carried out. It was proved that the state cannot fulfill its financial obligations to provide the health care system with budget funds at the level of at least 10 % of the national income, which are declared in the Law of Ukraine 'Fundamentals of Ukrainian legislation concerning to the health care system'. The stages of reforming the health care system in recent years were disclosed, their feasibility and level of execution was analyzed. It was revealed that the reform of the health care system is inconsistent and fragmented. In particular, every year the government proposes new reform measures, while the past measures have not been implemented. This significantly hinders the development of the health care system and its improvement. It was proposed to approve the norms for financial support for various types of medical services, identify and separate the sources of their financing, create the unified accounting system for the costs of the industry.