The paper analyzes the health care sector functioning at the national level, in particular, the dynamics of the budget financing of the health care system of Ukraine for 2004-2017, the growth rates of total expenditures on health care by sources of income; estimates total expenses on health care per capita and in relation to the GDP of the state; analyzes the expenditures on health care in the regional dimension taking into account the level of provision of residents with medical care. This made it possible to assess the current state of financial provision of the sphere and the state’s ability to provide social guarantees to every citizen regarding health care. The trends and obstacles of the functioning of medical insurance in the national and regional dimensions are outlined in this article, namely: the dynamics of volumes and growth rates of gross and net insurance premiums and payments in the market of voluntary medical insurance of Ukraine are analyzed; indicators of the amount of insurance premiums received from individuals and legal entities are compared; the parameters of development of the market of medical insurance in Ukraine are determined; the assessment of the concentration of insurers on the volume of collected premiums for this type of insurance, as well as the presence of foreign capital and its impact on market development is conducted; the rating of regions of Ukraine according to the volumes of collected insurance premiums for voluntary medical insurance are determined. This allowed to identify the key problems and preconditions for the introduction and development of an obligatory health insurance system in the context of modern healthcare transformations. Analysis of programs of insurance companies, tax and regulatory regulation of health insurance in Ukraine shows the volatility of the market and the low level of readiness of the state to introduce obligatory health insurance. In contrast, there is a steady increase in the population covered by health insurance. This testifies to the readiness of the population to introduce insurance principles in the medical sphere. On the basis of the data, there is a significant differentiation in the financing of health care in different regions, and there is also a significant difference between urban and rural populations regarding the quality and efficiency of provision of medical services. The development of health insurance in a regional dimension is characterized by strong differentiation. The dynamics are growing, despite the fact that the share of insurance premiums from voluntary health insurance in the total amount of collected insurance premiums in the regions is still negligible. 

health care, voluntary health insurance, obligatory health insurance, gross insurance premiums, gross insurance indemnity, regions 

The key aspects of the integrated approach to the implementation of health insurance principles in health care in the context of reform are outlined. The distribution of the levels of protection of health protection according to the sources of financing to the primary, basic and service is carried out. The mechanism of functioning of compulsory health insurance in Ukraine is proposed, which includes organizational and financial components. The institutional component of the mechanism involves the creation of a Health Insurance Bureau, regional funds and the involvement of exclusively «trusted insurance companies», whose activities are regulated by law. Financial instruments include contributions from insurers, allocations from state and local budgets, certificate cards for each insured person. It is determined that the purpose of the financial mechanism is to increase the effectiveness of the formation and use of financial resources and to ensure the protection of public health. 

health care, mechanism, health insurance