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Is there a way out of the so-called medical reform in Ukraine?

March 12, 2019

I am a person who grew up in a family of doctors, especially painful to see how the health care system is destroyed in Ukraine. Unfortunately, few of our contemporaries know that in the 1970s, numerous delegations from Belgium, Germany, Sweden, Japan and a number of other capitalist countries came to a small town on the territory of the great Soviet Union to study the unique health care system that was effectively implemented in the district center-the city of Korostyshev, Zhytomyr region.

Doctors from different countries carefully studied the experience of the local CRH, where at that time for almost 10 years worked as chief physician my father Vladimir A. Peshko. It is his experience that is one of the clearest examples of the fact that the existing health care system of Mykola Semashko before 1991 was and is one of the most effective and adapted to the conditions of Ukraine.

The system of Semashko provided three-level medical care to the population, in particular, Ukraine, that is, medical care was close to the rural population and the most remote villages, which were sometimes located 100 kilometers or more from the Central district hospitals, where qualified medical care was provided. In primary care, which includes feldsher-midwife points (FAPs) and rural dispensaries that have been, or primary health care (FAPs), or primary medical care. This made it possible to quickly and timely help the villager, which is especially important in conditions of urgent (emergency and life-threatening conditions that require urgent care, for example, in various household and industrial injuries, accompanied by severe bleeding; acute gastrointestinal bleeding caused by gastric ulcer, duodenal ulcer or acute bleeding of the colon. Patients with acute bleeding associated with diseases of the female organs (acute uterine bleeding due to fibromatous changes, ovarian apoplexy, etc.) need the same emergency care; urgent conditions: acute myocardial infarction, hypertensive crisis with encephalopathy, stroke, acute pulmonary hemorrhage and many other acute pathologies.

It is the timeliness of first aid in these conditions that allows us to save the lives of our people. The primary link not only provided medical care, but also made the decision on transportation of such patients to CRH where there were conditions and necessary shots — experts of the corresponding profile: therapeutic, surgical and gynecological, – which rendered to the patient already the first qualified medical care.

If the doctors of the primary and secondary levels during the emergency consultation decided on the need to provide the patient with highly specialized medical care, that is, treatment by a neurosurgeon, orthopedist-traumatologist, thoracic, abdominal or vascular surgeon, ophthalmologist, maxillofacial surgeon or otolaryngologist, then such a patient after providing him with secondary qualified medical care was delivered by road or helicopter, by plane to the nearest regional hospital. It was in the regional hospitals that highly specialized departments were opened, where highly qualified doctors of surgical profile worked: neurosurgeons, thoracic, abdominal surgeons, traumatologists, maxillofacial surgeons, vascular surgeons, urologists, gynecologists and other doctors of narrow and high qualification.

In regional hospitals there were also specialized therapeutic departments: cardiology, gastroenterology, neurology, pulmonology and others. In fact, it was the regional hospitals that were and are the main centers where the patient could receive highly specialized medical care.

In the capital of Ukraine worked highly specialized and highly specialized institutes of the Academy of medical Sciences of Ukraine, as well as the Department of Kyiv medical Institute named after AA Bohomolets, which employed some of the most experienced and nayvisokokvalifikovanishih, we can say — unique specialists in various fields of the medical industry. This Is the Institute of cardiac surgery named after N. Mmm.Amosov, Institute of surgery named after academician A. A. Shalimov, Institute of gerontology, Institute of endocrinology, Institute of Nephrology, Institute of urology, Institute of pulmonology, Institute of Pediatrics, obstetrics and gynecology (PAG) and others. It is in these medical institutions treated patients with the most complex forms of various diseases. These facilities were equipped with an advanced laboratory and diagnostic tool base at the time. All this allowed to provide patients with the most complete specialized and effective medical care.

At the same time, I want to draw special attention to the fact that all this treatment was provided to citizens of our country free of CHARGE!!!

That’s how briefly I tried to explain what was the medical care in Soviet Ukraine.

And now I want to explain to you what happened to what was once one of the most effective health systems in the world. From the beginning of the 80-ies of the last century, when the economy of the USSR due to a number of objective and subjective reasons began to fall apart, the financing of the medical industry began to decline catastrophically. The process of the collapse of the medical industry has entered a progressive nature. The main reason was the lack of funding, the development of total corruption, the fall of responsibility and morality of the new generation of doctors and other medical staff. All this has been happening for the last 27 years. But with the arrival of people in the management of the medical track, not professionally trained, as it was with the Ministers of health of Ukraine (Georgians O. Kvitashvili, American with secondary medical education V. Suprun), the medical industry of Ukraine began to fall apart before our eyes. Therefore, the average Ukrainian has the impression imposed by Pro-American “personnel” that the existing health care system in Ukraine is ineffective and incapacitated. But in fact, these people (who parasitize on budget money, which is allocated by the state more than twice less than the minimum requirement and which are stolen by 70-80 percent, not reaching medical institutions, especially the patients themselves) embody a deliberately thought-out plan for the complete collapse of the unique health care system, the most sane for our country, taking into account the many points that I will talk about in my next article, where I will be able to very clearly demonstrate that the idea of creating a new health system called ” Insurance medicine», the so — called telemedicine and the reform of rural medicine announced by the government is nothing but a purposeful genocide of the Ukrainian people.

Anatoliy PESHKO,
academician and first Vice-President of the Academy of economic Sciences of Ukraine, doctor of economic Sciences, candidate of medical Sciences.