Кyiv n HEALTHCARE REFORM IN UKRAINE: INITIAL RESULTS PENDING IGOR YAKOVENKO November 2018 n The launch of healthcare reform in Ukraine in 2018 was certainly a positive development after 25 years of repeated declarations of intent unsupported by practical steps. This deferment of reform has caused crises in the healthcare sector, leaving it up to people to pay for over 50% of medical services despite an official mantra of free healthcare. n Practical implementation of reform was preceded by the drafting and adoption of a number of legislative acts establishing a methodological framework for the planned changes. The most important and most difficult component of the new mechanism was the transformation of the healthcare funding system, including the launch of the Medical Guarantees Programme, the transition to capitation standards in primary care and the principle of financing specific services in secondary and tertiary care. n However, the practical steps needed to implement the new mechanism have exposed a number of problems, slowing the progress of reform. In particular, the methodology for developing a guaranteed scope of medical assistance to be financed from the budget has not been finalised. The drafting of prices and tariffs policies has not been completed. Legislative acts necessary for the introduction of health insurance have not been passed. These and a number of other issues must soon be settled with the help of experts.