Lytvynenko M. Mechanisms for Implementation of the State Policy of Reforming Health Care System in Ukraine

The thesis deals with theoretical principles and system of means of reforming the health care system in Ukraine. It is determined that the reform of the health care system in Ukraine is to solve systemic problems of the medical sphere of Ukraine, to create an effective system of health care and ensure the rights of citizens to health care. It is emphasized that there is the expediency and objective necessity to change the role of the state as the main subject of health management to the role of the subject of regulation of the specified sphere. The content of the concept of "mechanism of implementation of the state policy of reforming the health care system" is disclosed - it is viewed as a dynamic functional system, the components of which are interrelated as structural and organizational ones (principles, methods, tools, etc.) and structural and functional ones (technologies, procedures, regulations, plans and programs for the implementation of state policy in the field of health care) through which the harmonious combination of solutions to existing problems in the industry are provided and conditions are created to minimize their occurrence in the future with the aim of ensuring qualitative changes in the system of public administration for the development of the medical sector, the establishment of an effective system of health care and guaranteeing the rights of citizens to access medical care. It is proved that the introduction of such a mechanism in the public practice of reforms should provide for certain prerequisites, namely: awareness and support of the of the subject pursuing the goal of transformation; efficient activity of the governing body for the promotion of new norms; approval and support of new values by other subjects of this social space; effective integration of new ideas into public consciousness; loss of leadership by the authorities in this process and the active inclusion of the population in the process of approving new norms. It was determined that the implementation of medical reform, which began in the fall of 2017, faced numerous risks, the most important of which is the unwillingness of the system to have it implemented. Institutional weakness of the management system, controversy in the adopted legislation, low level of coordination and cooperation between representatives of various branches of government, low level of trust in the reform by medical professionals and the population, inconsistency of medical reform with the process of decentralization, etc. are also viewed as threats.