Ukraine

Health and welfare

In theory, all citizens of Ukraine are constitutionally guaranteed free and effective health care. In practice, health care is financed through a combination of state and private funding, and money for improvement in the system remains scarce. Prepaid sickness funds provide their members with some measure of insurance, but a sizable percentage of health care costs are incurred as out-of-pocket expenses. Ukraine emerged from the Soviet period with an extensive infrastructure of health care facilities, including hospitals, workplace- and school-based medical centres, retirement communities, and women’s clinics, but these facilities deteriorated badly during the postindependence economic downturn. A lack of medicine and equipment, underfunded medical schools, and low wages for health care providers also have contributed to a significant decline in the quality of health care. Of particular concern was the spread of HIV/AIDS, especially among the country’s intravenous drug users.

Following independence, the social welfare system of the Soviet period was restructured and expanded. Benefits were partially linked to inflation, and measures were adopted to assist workers displaced by the transition to a market-oriented economy. Other components of the social insurance system include family allowances for households with children, birth and maternity benefits, and disability pay. The welfare system is financed through a payroll tax. This system came under increasing pressure as the ratio of workers to retirees narrowed in the early 21st century, and pension funding consumed an increasingly large portion of the government’s budget. A small but growing percentage of Ukrainians participated in private pension funds.