Fedorova N. Development of health insurance in the system of state regulation of insurance activity in Ukraine

The dissertation is devoted to the substantiation of theoretical positions, the development of methodological approaches and practical recommendations for the development of health insurance in the system of state regulation of insurance activity on the territory of Ukraine. The theoretical principles of development of insurance activity as an object of state regulation are investigated in the dissertation; the conceptual-terminological apparatus of state regulation of development of insurance activity is investigated; the basic mechanisms of regulation of insurance activity in the healthcare system are defined and characterized; the factors influencing the development of medical insurance of Ukraine are systematized; the features of medical insurance on the territory of Ukraine are revealed; the state of state regulation of the provision of health insurance services in Ukraine is assessed; the factors of containment of the development of voluntary medical insurance are revealed, as well as foreign experience of state regulation of insurance activity is researched. It is established that at the present stage the problem of state regulation of insurance activity of Ukraine in the medical sphere is extremely urgent and at the same time polyhedral. Indeed, as for today insurance activity in Ukraine is characterized by low efficiency, unsatisfactory level of coverage of processes that require insurance, shortage of financing of the industry. At the same time, low level of public awareness in this sphere, distrust of insurers leads to a low coefficient of involvement of citizens in this type of services. That is why the study of the direction of implementation of effective insurance instruments for the development of the medical sector should be given special attention by scientists and practitioners, taking into account the importance of issues, financial and technical constraints on the provision of quality and affordable health services. Assessing the risks and factors of the impact of insurance on the development of the social and medical sphere in particular, developing effective proposals will allow a comprehensive approach to solving the issue of ensuring sustainable socio-economic development of Ukraine. The main tendencies of the Ukrainian insurance market development are considered. Among them: a gradual increase in the density and penetration of insurance, the amount of insurance premiums and voluntary insurance contracts, and the reduction of the number of insurance companies. The modern requirements for state regulation of the insurance market in the medical sphere in the context of reforming the health care system are described. The SWOT analysis of the voluntary health insurance market on the territory of Ukraine was carried out. On the basis of the analysis, in order to identify corrective actions aimed at eliminating weaknesses and threats to the development of this sphere, a strategy for optimization and further development of the insurance market of Ukraine has been developed. The comparative analysis of the main principles of functioning of the health care system of Ukraine before and after the implementation of medical reform was carried out on the following criteria: the essence of the medical care provided; financial security; manager of funds; the mechanism of relationship «supplier – customer» of medical services; subject of financing; management of medical information. The necessity of introducing a new mechanism of state compensation for part of the insurance premium for voluntary medical insurance for the poorer sections of the population is substantiated. A new model of interaction between the subjects of the market of voluntary medical insurance is developed, which provides provision of high-quality, timely and accessible medical services to the population of administrative units of different levels with control by the state in the person of the Ministry of Health, the National Financial Services Commission and local self-government bodies for the activities of medical institutions and insurers. Recommendations for the implementation plan of a communication campaign on the introduction of a new mechanism for voluntary medical insurance are formulated. A questionnaire (questionnaire) for a sociological survey was developed during a communication campaign on the state aid program for voluntary medical insurance.