HEALTH FINANCING REFORM IN UKRAINE
Figure 2.13 shows that despite the deteriorating fiscal situation, the share of spending on education, economic activities, defense, and security and the judiciary significantly expanded. The 2020 COVID-19 budget amendments sharply increased the share of the consolidated government budget going to health to 10.4 percent, equivalent to 4.24 percent of GDP. Reacting to COVID-19, the central government increased the planned allocation to health care, including earmarked health grants, by 1.0 percent of GDP, which helped expand the share of health within the central budget from 9.6 percent to 10.9 percent. The SNGs also increased their health care allocations funded from their revenue on top of earmarked health grants by 0.2 percent of GDP. Together, these measures helped raise planned consolidated health spending to the highest level in recent times (figure 2.12). However, investment in some nonhealth infrastructures received an even higher priority— for example, as shown in figure 2.13, consolidated spending on economic activities grew by 1.6 percent of GDP (within which, spending on roads increased by 2.1 percent of GDP). The 2021 budget further increases central spending on health to 12.1 percent of total government spending, equivalent to 3.6 percent of GDP. At the time of writing, though the 2021 Budget Law containing the central budget health allocation was already approved, the SNGs had not yet approved their budgets, making it impossible to establish the consolidated 2021 health budget projections. At the central level, the 2021 budget signals a slight change in functional priorities. As already stated, central spending on health, including transfers to SNGs, would
FIGURE 2.13
Largest functions as a percentage of consolidated expenditures, 2007–20 30
25
20
15
10
5
Social protection Security and judiciary
Education Defense
Economic activities Debt servicing
Sources: State Treasury Service of Ukraine; State Statistics Service of Ukraine.
Health care
20 20
19 20
18 20
17 20
16 20
15 20
14 20
13 20
12 20
11 20
10 20
09 20
20
08
0
07
% of consolidated expenditures (all tiers)
|
20
42
