Business news from Ukraine

Business news from Ukraine

Private clinics in Ukraine propose to revise approaches to cooperation with state

Private healthcare facilities are ready to work under the Medical Guarantee Program (MGP) and propose to revise approaches to the formation of certain packages for the MGP, which will reduce the cost of medical services and optimize budget expenditures.

This was stated by members of the Association of Private Medical Institutions (APMI) at a press conference at Interfax-Ukraine on Thursday.

Mykola Skavronsky, deputy director general of the Cinevo medical laboratory, noted that the laboratory has not stopped working since the beginning of the war, despite the fact that in 2022 Cinevo lost more than 30 branches in different regions.

“It’s quite a shame to see that recovery programs exist only for state or municipal medicine. This completely ignores the fact that private medicine also suffered from the war. But, unlike the state and municipal ones, all private providers are recovering and continue to work with their own or credit funds, not with budget funds and without assistance,” he said.

Commenting on the first experience of Cinevo’s cooperation with the NHSU in 2024, Skavronsky noted that the laboratory’s entry into the PMG “became a kind of spotlight that highlighted the situation with the laboratory industry in Ukraine as a whole.”

“I can say that the state does not know and does not understand the real need of doctors and patients for laboratory diagnostics. Now it is believed that laboratory diagnostics are needed as much as they are ordered, not as much as they are needed. Cinevo’s cooperation with the NHSU has revealed the fact that there is simply a huge unrealized demand for laboratory diagnostics in Ukraine, in March last year alone, we performed almost 730 thousand tests for 72 thousand people, and we saw that of these people who came to us for PMG, two-thirds were new people,” he said.

Skavronsky noted that at basic prices, Cinevo performed tests for about UAH 528 million, at prices, the cost of tests was about UAH 200 million, while the NHSU paid UAH 44 million for them.

“We asked the NHSU to create a laboratory package that would be transparent and clear, where it would be clear what tests and, most importantly, which doctors can prescribe them and in what quantity. Because it turned out that there were no restrictions at all, doctors prescribed tests that should not have been prescribed. It is not the laboratory that should decide what to do and what not to do, there should be a system that simply does not allow prescribing something wrong,” he said.

According to Skavronsky, one of the most popular tests funded by the budget in 2024 was vitamin D tests, of which the laboratory performed about 100 thousand.

“I don’t think Ukraine is such a rich country to cover vitamin D tests in such volumes at the expense of taxpayers. But doctors prescribe them. Why doctors prescribe them is a bigger question for doctors and pharmaceutical companies,” he emphasized.

Skavronsky also emphasized that the implementation of the proposals developed by the laboratory allowed “not only not to increase the tariff, but even to reduce it.”

“As a private laboratory, we would be ready to work with tariffs that are 15% lower, but subject to clear criteria. In recent years, we have heard that money follows the patient, but over the past year, especially in the first quarter, we have seen that money does not follow the patient,” he said.

For his part, Vadym Zukin, Chief Operating Officer of the Leleka Multidisciplinary Medical Center, reminded that Leleka is the only medical center in Ukraine that has international JCI accreditation, and the clinic received its latest confirmation at the end of 2024.

“Literally two months before the full-scale invasion began, the Minister of Health and his deputy came to us and we discussed how these standards could be implemented for other market players. But now it seems that the state is sailing its own ship, and we are trying to catch up with the Ministry of Health and convince it of something,” he explained the situation.

Zukin emphasized that “the state should realize that it is more profitable for it to become a purchaser of medical services rather than a provider and not to invest in fixed assets, since private companies already have these funds.”

He also suggested that the NHSU should enter into longer-term contracts for participation in the PMG.

“Currently, certain PMG packages will have three-year contracts, which is better than one year, but it means nothing, because in Europe and the US they think in terms of seven years, 10 years, 15 years,” he said.

Zukin believes that “now the reform has started to move a little bit in the opposite direction from the notion that money follows patients, and I would like to bring it back in the right direction.”

For her part, Oleksandra Mashkevych, medical director of the Dobrobut medical network, noted that the network is a major taxpayer, employing 3,000 people, including 1,300 doctors. At the same time, 131 employees have been mobilized from Dobrobut and the clinic continues to pay their salaries.

“We are recognized by the Ministry of Health as critical infrastructure. In 2024, we invested almost UAH 0.5 billion in our development, most of which was spent on our energy efficiency. I would like to note that investments in energy efficiency in state and municipal institutions are not made at their own expense, but at the expense of the state or donors or sponsors. We do it on our own,” she said.

At the same time, Mashkevych emphasized that Dobrobut’s cooperation with the NHSU is “quite interesting.” In particular, the clinic has been contracted for a package of assisted reproductive technologies, under which 300 patients have completed treatment cycles and almost 45% of women have already confirmed pregnancy status.

“The tariff for this service was too low for us, we worked in the red, realizing that we were lending a hand to the state, in fact, we gave the state the opportunity to use our facilities to provide free medical services. We had long rounds of negotiations with the NHSU, the Ministry of Health, and the Ministry of Finance, and they heard us and increased the tariff. This tariff does not cover all our expenses, but we continue to work with it,” she said.

Commenting on the plans to work with the NHSU, Mashkevich noted that Dobrobut plans to expand its participation in the UHI-2025 and is waiting for the NHSU’s decision on contracting for new packages.

At the same time, Mashkevych called it a positive decision to allow private institutions to use the state unified portal of medical vacancies launched by the Ministry of Health.

The press conference was organized by the Interfax-Ukraine agency and the Association of Private Medical Institutions.

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Association: Ministry of Health of Ukraine creates discriminatory conditions for private clinics

The Ministry of Health continues to impede the entry of private clinics into the medical guarantees program and creates discriminatory conditions for their participation in the single medical space.

This opinion was expressed by members of the Association of Private Medical Institutions (APMI) at a press conference organized jointly with Interfax-Ukraine on Thursday.

“We have tried many times to reach a dialogue with the relevant ministry, but, unfortunately, we have been ignored in all formats – official, unofficial, absolutely in all. Therefore, we were forced to send an open letter. It is unfortunate that the Ministry of Health demonstrates its intention to continue ignoring us and our problems. This is evidenced, in particular, by the regulatory documents approved after our appeal,” said Olena Yeshchenko, director of Smart Medical Septeg, chairman of the APMZ.

She explained that the regulations put private clinics in a non-competitive position with state or municipal healthcare facilities. “They create artificial obstacles aimed at removing large private providers, healthcare providers from the system, which ultimately leads to unnecessary spending of public funds and their misuse,” she said.

According to Ms. Yeshchenko, these are the requirements of the Primary Healthcare Program 2025, which relate, in particular, to the requirements for laboratory tests, as well as the introduction of reduction coefficients for private clinics when paying for medical services provided under the Primary Healthcare Program, as well as requirements that make it impossible to include private institutions in a capable network, etc.

She emphasized that the issue of booking medical staff is becoming especially relevant for private clinics. “We are talking about a number of very serious discriminatory issues, for example, when it comes to booking medical staff. Even after our appeal, the government approved a 100% quota for booking medical staff for state and municipal institutions, but this is not provided for private institutions, although many private clinics continue to operate and provide medical care to the military and the wounded at their own expense,” she said.

“Thus, in our opinion, a rather corrupt component is being implemented, which contributes to the outflow of medical workers from private medicine to state and municipal institutions,” emphasized Yeshchenko.

According to her, there is currently a problem of communication on this issue between the Ministry of Economy and the Ministry of Health. “In fact, the two ministries are trying to play football with each other,” she said.

For her part, Oleksandra Mashkevych, medical director of Dobrobut Medical Network, noted that Dobrobut, which is included in the list of critical infrastructure facilities, is also deprived of the possibility of booking.

“Dobrobut Medical Network is a critical infrastructure facility. As far as I know, there are only 11 healthcare facilities classified as critical infrastructure facilities. And I have a question: why we are not included in the resolution on booking 100% of doctors. We will honestly say that our healthcare workers are likely to move to state-owned and municipal facilities, because there is an opportunity to book there,” she said.

As reported, at the end of December last year, the APMH in an open letter to government agencies stated that the Ministry of Health violates the rights of citizens and prevents private institutions from entering the single medical space and the PMG.

 

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Ukraine’s public debt increased by $22.7 bln to $166 bln over year

Ukraine’s total public debt in 2024 rose to a new all-time high: by $22.74 billion, or 14.3%, to $166.06 billion in dollar terms, and by UAH 1 trillion 461.3 billion, or 26.5%, to UAH 6 trillion 980.9 billion in hryvnia terms, according to the website of the Ministry of Finance.

According to the data, the direct public debt increased by 16.5% in dollars to $159.20 billion, or UAH 6 trillion 692.4 billion, and accounted for 95.9% of the total public and publicly guaranteed debt.

In 2024, Ukraine’s total external public debt increased by 18.1%, or by $18.38 billion, to $114.88 billion, while the total internal public debt increased by 16.7%, or by UAH 276.0 billion, to UAH 1 trillion 863.1 billion.

As a result, the share of total external public debt increased from 70.0% to 72.3% over the year.

According to the Ministry of Finance, the share of liabilities in euros at the end of 2024 increased to 33.01%, in US dollars to 26.81%, in SDRs to 11.39%, in Canadian dollars to 2.83%, in British pounds to 0.11%, while in hryvnia it decreased to 25.33% and in yen to 0.51%.

The agency also clarified that 65.01% of the state debt has a fixed interest rate, while 11.39% is tied to the IMF rate, 12.66% to SOFR, 3.80% to EURIBOR, 0.51% to TORF and 0.10% to SONIA.

The rate for another 2.08% of government debt is tied to the consumer price index, and 4.17% to the NBU discount rate. These are government bonds from the NBU’s portfolio. The newest of these were the securities linked to the key policy rate, which the NBU bought as part of the issue financing of the 2022 budget.

Finally, 0.27% of the state debt has a rate linked to the Ukrainian index of rates on retail deposits, which is used in portfolio guarantee programs.

The Ministry of Finance previously noted that Russia’s full-scale invasion of Ukraine in 2022 led to a sharp increase in the ratio of public debt to GDP – from 43.3% at the end of 2021 to 79.4% at the end of 2023.

As reported, Ukraine’s public and publicly guaranteed debt increased by $13.4 billion in 2022 and by $33.9 billion in 2023.

The IMF, as part of the sixth review of the EFF Extended Fund Facility program with Ukraine last December, improved its forecast for public debt growth due to higher GDP growth and lower deficits: to 92.2% of GDP by the end of 2024 and to 104.3% by the end of 2025, while in October it estimated it at 95.6% of GDP and 106.6% of GDP, respectively.

Earlier, the Experts Club think tank and Maxim Urakin released a video analysis on the state of debt in the world, see more details on the YouTube channel: https://youtu.be/gq7twYrWuqE

 

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Trump administration is taking first steps to change regulation of cryptocurrency market

The administration of the new US President Donald Trump is taking the first steps to change the regulation of the cryptocurrency market. During his election campaign, Trump promised to create a more friendly environment for crypto assets.

Mark Ueda, the acting chairman of the U.S. Securities and Exchange Commission (SEC), announced the creation of a working group to “develop a comprehensive and clear regulatory framework for crypto assets.”

“The task force will help the SEC define clear regulatory boundaries, propose realistic pathways for registration, develop reasonable disclosure schemes, and prudently allocate resources for enforcement,” the regulator said in a statement.

Ueda is acting as SEC chairman temporarily while Trump’s nominee, lawyer Paul Atkins, awaits confirmation by the Senate.

Earlier, the Experts Club think tank, Brian Mefford and Maxim Urakin, released a video analysis of what changes await US domestic and foreign policy under Trump, the video is available on the Experts Club YouTube channel – https://youtu.be/W2elNY1xczM?si=MM-QjSqGce4Tlq6T

 

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European Central Bank President: Europe needs to prepare for increase in duties on imports of goods to United States

Europe should be prepared for a possible increase in tariffs on imports of goods to the United States, as promised by President Donald Trump, said European Central Bank (ECB) President Christine Lagarde. The fact that Trump has not yet signed a decree to impose additional duties on all imports was “a very sensible approach, as total tariffs will not necessarily lead to the expected results,” Lagarde said in an interview with CNBC in Davos.

In her opinion, the new US tariffs will be more “selective and focused”.

“We in Europe need to prepare and wait in advance to see what will happen in order to respond to it,” Lagarde added.

At the same time, the ECB President noted that the regulator is “not too concerned” about external risks to inflation.

In response to a journalist’s question about the possible consequences of a new wave of inflation in the United States, Lagarde said that “accelerating inflation in the United States will be a problem for the United States, and that is where the main effects will be felt first.”

The ECB has cut rates by a total of 100 basis points in 2024, with the key deposit rate now at 3%. Economists expect four rate cuts of 25 bps each in 2025. Earlier, the Experts Club think tank, Brian Mefford and Maxim Urakin, released a video analysis on what changes are expected in US domestic and foreign policy under Trump, the video is available on the Experts Club YouTube channel – https://youtu.be/W2elNY1xczM?si=MM-QjSqGce4Tlq6T

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Trump lifts moratorium on issuing new liquefied natural gas export licenses

US President Donald Trump has lifted the moratorium on the issuance of new liquefied natural gas (LNG) export licenses imposed by his predecessor Joe Biden. The US Department of Energy reported that it is returning to the normal regime of reviewing export applications in accordance with Trump’s order.

“The Department has been instructed to resume reviewing applications for the export of US LNG to countries that do not have a free trade agreement with the United States. The proper review of export applications is required by law and must be carried out accordingly,” the Energy Ministry said in a statement.

In December, the agency published the results of a study on LNG exports and set February 18 as the deadline for public comments on it. Now the Ministry of Energy has decided to extend the comment period until March 20, 2025.

Earlier, the Experts Club think tank, Brian Mefford and Maxim Urakin, released a video analysis on what changes are expected to occur in US domestic and foreign policy under Trump, the video is available on the Experts Club YouTube channel – https://youtu.be/W2elNY1xczM?si=MM-QjSqGce4Tlq6T

 

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