HYBRID HEALTH INSURANCE MODEL: FOREIGN EXPERIENCE AND SCENARIO FORECAST OF IMPLEMENTATION IN UKRAINE

Abstract

The article presents a comprehensive analysis of the prospects for the development of a hybrid health insurance model in Ukraine based on the integration of public and private health financing mechanisms. The study summarizes the international experience of countries that have undergone post-war or post-crisis recovery and implemented mixed insurance systems to stabilize their health sectors, strengthen financial protection and modernize medical infrastructure. Particular attention is paid to the successful experience of Germany, Croatia, Poland, Rwanda and Israel, where hybrid models have effectively balanced state responsibility and competitive private insurance instruments, supporting technological innovation and restoring access to medical services. The current state of the Ukrainian health care system is considered, which is characterized by high budgetary pressure, underfunding, unequal access to services and significant infrastructure losses caused by the full-scale invasion and military operations on the territory of Ukraine. It is proven that during the post-war reconstruction Ukraine needs multi-channel financing instruments that can ensure a balanced contribution of the state, employers, households and private insurers. The use of scenario analysis allowed to develop potential trajectories of the implementation of different models - from a moderate expansion of co-financing to a fully integrated mixed system that combines mandatory and voluntary components of insurance. The main advantages and risks of the following scenarios of combining state and private health insurance in Ukraine were identified: basic (conservative); hybrid (combined, “European”); staged (phased, transitional); solidarity public (partly following the example of “community-based”). The results of the study indicate that the implementation of a hybrid health insurance model can become a key tool for the restoration and ensuring the long-term sustainability of the Ukrainian healthcare system. Combining international experience with national conditions allows us to identify realistic mechanisms for financial stabilization, improving the accessibility and quality of services, and creating institutional foundations for modernization of the sector in the post-war period in accordance with the defined sustainable development goals.