Інституціонально-еволюційна трансформація медичного страхування в Україні

Abstract

Розглянуто основні положення інституціонально-еволюційної теорії. З позиції інституціоналізму визначено періодизацію трансформаційних перетворень страхових відносин у сфері медичного страхування, встановлено основні інституціональні зміни. Окреслено організаційну структуру та інфраструктуру інституту медичного страхування, напрями взаємодії між його суб’єктами. Виокремлено три інституційні моделі розвитку медичного страхування в Україні і доведено переваги його інституціонального розвитку. Introduction. Modern economic changes require the formation of relevant theoretical and methodological framework that will enable to fully reveal the characteristics and solve the problems of health insurance in the context of improving the quality of medical services and guarantee the receipt of medical care. One of these areas of economic science, will serve as a methodological basis for the study of health insurance is the institutional theory, the use of which when considering the evolution of health insurance consider it necessary and appropriate, for signifi cant institutional prerogative of the analysis is to cover all its fi elds of social development. Purpose. To study the evolution of medical insurance in Ukraine and identify priority institutional model of development. Results. Institutional and evolutionary processes in the area of health insurance took place in several stages. First stage of institutional changes to of health insurance (1988–1995 gg.) Characterized the formation of new formal and informal institutions, of the rapid establishment of insurance companies, of the development of the insurance market. For the second stage of transformations in the system of insurance relations (1996–2000) characterized by the development of organizational support health insurance, insurance intermediation, create assistance companies to coordinate work on service insured by health insurance. In the third stage of market transformations (from 2001 - present day) is further reform of health insurance in the context of institutional change. It was found that the defi ning characteristic of the institute of health insurance system the insurance relationship is the relationship between the entities that form the institutional and organizational environment of social and economic institution. Characterized institutional entities health insurance. Conclusion. In our view, it is useful to distinguish three institutional model of health insur- ance: I model that was based on the operation of mandatory health insurance, dominated by state medical insurance company, the Medical Benefits Fund; II model – voluntary medical insurance, which is the main entities are commercial insurance companies; III mixed model, which provides health insurance to the functioning of compulsory and voluntary form and the combination of both state and commercial structures. In our opinion, the most appropriate is a third institutional model, which will be optimal combination of economic interests of all participants in health insurance and ensured reliable insurance protection for people who may lose their health or life.