Doctor's salary and future in Ukraine

[Wayne]

Ukraine. The position of Ukrainian doctors in the public health care system is worse than that of their Russian or Belarusian colleagues. According to data from the State Committee of Statistics, the average wage of Ukrainian doctors is USD 294. After the basic salary was recently increased for budget-funded occupations, the top-category therapeutist got their salary increased by UAH 125 (USD 15).
 
How does the Ukrainian doctor make both ends meet if:
• Ukraine has never spent more than 3% of the state budget on health care (same provisions are made for 2011).
• the basic salary of a district therapeutist is up to UAH 1,000 (USD 125). Of course, the salary is increased by increments for harmful conditions, category, medical degree, teaching. For example, a top-category anesthesiologist who has a medical degree of a candidate and teaches as an associate professor at a university's department can get USD 375-440.
• an experienced doctor of emergency care and cardiac surgeon of N. Amosov Institute in Kiev get USD 250-340 (like a security officer at a supermarket or a doorkeeper at a prestigious hotel).
• actual salaries of practicing doctors are USD 199 or 30% lower than the official level.
• shortage of doctors in Ukraine is 46,000 specialists. Public health care becomes 6,000 doctors short every year as they get retrained or emigrate. 40% of the active medical personnel is retirees.
A visa-free regime that can be introduced with the European Union will trigger a large-scale flight of medical personnel from the country and a collapse of the public health care system.

[ML]

Yes, I agree one of the looming disasters in Ukraine (and also Russia) is the low pay for medical doctors, professors, and teachers.

The future hangs in the balance.

[Hammer2722]

I've been told that doctors and nurses in Ukraine will get cash payment by patients or their family members to ensure that the patients recieve good care. One lady that I dated used to work as a trained nurse but gave it up to be a manicure master because her income was significantly higher than as a nurse. Its a sad thing.

[Gator]

I spent some time with a MD in 2002.   Her salary was $30/mo.  Of course she could not survive on such low pay.  So her patients gave her "under the table payments."  Payment was frequently cash, but it could be a ham or bartered services.

[Jumper]

Doctors are not well paid there, officially.

yet its difficult to find a doctor living *less* than the average person.
Most do quite a bit better, none do worse or average.

doctors in private clinics do well.
Those in public sector do also, with bribes and additional payments.

Healthcare is far from free to a Ukrainian looking for good decent treatment in a timely manner.Its accepted practice to grease the wheels.

[roykirk]

My guide on Mt. Elbrus many years ago had been a well respected pediatrician in Ukraine.  He quit completely to guide clients in the Caucasus because he said the pay was many times more what he could make as a doctor. 

[Chicagoguy]

My wife's sister is a retired cardiologist in Kiev. Her husband was telling her that she made enough money to keep their car supplied with gas.

[Shadow]

So this is the real reason many in the US are against Obamacare...

The salaries are a relic of the old Soviet system, where health care was free and people were used to freely contribute something for good service.
Becoming a doctor was a calling for people wishing to cure others, not a way to make big cash.

[Wayne]

It is a lot cheaper and quicker to become a doctor in Ukraine than USA. You don't need to run up student loans. Of course, becoming a doctor in Ukraine does not qualify you for USA, but it does work for some other countries. The Crimean State Medical University has some students from English speaking countries, and offers classes in English.
 
My wife says that the teachers who teach classes in English get paid more than the ones who teach in Russian. Ukrainian language is not used much.
 
Teachers also do not get paid much in Ukraine.

[Vasilisa]

• the basic salary of a district therapeutist is up to UAH 1,000 (USD 125). Of course, the salary is increased by increments for harmful conditions, category, medical degree, teaching. For example, a top-category anesthesiologist who has a medical degree of a candidate and teaches as an associate professor at a university's department can get USD 375-440.

It's not about Ukraine but about Russia.
The salary there is higher than what you mentioned but not much.
Now about the "digits".
My friend broke 2 legs in an accident, he paid $2500 for 1 surgery "under the desk" to the surgeon whose official salary is around $800.

I had 2 teeth pulled out last year (hospital's surgeon), paid for each of them $100 (was about 30 minutes' work), do you want to count how much the surgeon really makes per month?!

[Wayne]

And so, Vasilisa, you say that the doctors get most of their money from under the table? That means they don't pay income taxes on most of their earnings?
I got sick while in Ukraine and know how this system works. I paid US dollars in cash for treatment from the doctor, he ordered several tests, untrasound, etc. I got treatment right away, he even had a terp for me.

 

[calmissile]

So this is the real reason many in the US are against Obamacare...

The salaries are a relic of the old Soviet system, where health care was free and people were used to freely contribute something for good service.
Becoming a doctor was a calling for people wishing to cure others, not a way to make big cash.

Yes, you finally got it!!
We do not want the US healthcare system to turn into a socialized medical system much like Ukraine and other similar systems.  Even Canadians come to the US in order to get treatment.  It does no good to have a  "free medical system" if you have to wait in line until you die to get treatment.

We already have doctors and clinics that refuse Medicare patients because their payments are much lower than private insurance.

You can continue to preach socialism and we will continue pushing back!  Since you are not here in the US, perhaps you will be much happier where you are and allow us to choose the type of government and economic system WE WANT.

[CDW]

I have a Ukrainian friend who is a doctor.  I never asked her about her salary, but she recently went on holiday in Cancun, Mexico and also to Egypt.  She doesn't look like she is a bank robber!!

[Vasilisa]

And so, Vasilisa, you say that the doctors get most of their money from under the table? That means they don't pay income taxes on most of their earnings?
]

you need to ask them, I am not a doctor, but I am telling you it's a common practice to "thank" doctors this way. I'd say surgeons and OB/gynecologysts make really good money. Other kind of doctors earn less. Physicians also may get something like some kind of food like candies/ expesive alcohol/cakes/buckets of berries or fruits or vegetables from dachas, etc.
What I am talking about is so-called "government hospitals" with low salaries which you mentioned, I am not talking about private hospitals, where they have an official price and pay taxes, etc.

[ML]

A Ukrainian business colleague of mine has a son who graduated from Veterinarian school a couple of years back.  He obtained a job at a top clinic and now has also developed several private clients on the side, and has other clients that he trains dogs for.

The father says that the son is making much more money than doctors who treat humans.

[Anotherkiwi]

A Ukrainian business colleague of mine has a son who graduated from Veterinarian school a couple of years back.  He obtained a job at a top clinic and now has also developed several private clients on the side, and has other clients that he trains dogs for.

The father says that the son is making much more money than doctors who treat humans.

A woman that I wrote and talked to for quite a while was a vet in private practice in St Petersburg (she's now married to an AM and divides her time between St Petersburg and the USA).  She told me that her standard call-out rate was the equivalent of $75, with a car and driver on permanent stand-by.  I don't imagine that too many average Russians could afford that much just to have someone look at their sick pet.
 
With the money coming in from actual treatments, I guessed that her income was quite possibly more than mine.  A real shame that we didn't get together, although we had made plans before she fell over this guy in the street.  She also has absolutely gorgeous identical twin daughters, both of whom spoke good English and were just starting university (at age 16!) when I was cyber-dating their mother.  I had one point in my favour - all three were suitably impressed that I could tell the girls apart.  However, as everyone here knows, it's rather difficult to compete in the Romance Stakes if you're half a world away.

[Wayne]

My ex RW had a little dog. She took better care of her and paid more attention the her than me.
The dog was 11 years old and had bad teeth. She bought expensive meat and ground it herself, because the dog would not eat any kind of dog food.
The dog had very long hair, that she had trimed in the summer. In the winter, she always put a coat on the dog before she would take her outside. I had to pay a lot to bring the dog on the airplane flights from Siberia. We spent a lot on things for the stupid dog!  She was in the vet's office several times.
The dog was not properly house trained and left messes in the house for me to clean up--not her!

[roykirk]

Yes, you finally got it!!
We do not want the US healthcare system to turn into a socialized medical system much like Ukraine and other similar systems.  Even Canadians come to the US in order to get treatment.  It does no good to have a  "free medical system" if you have to wait in line until you die to get treatment.

We already have doctors and clinics that refuse Medicare patients because their payments are much lower than private insurance.

You can continue to preach socialism and we will continue pushing back!  Since you are not here in the US, perhaps you will be much happier where you are and allow us to choose the type of government and economic system WE WANT.

I don't want to turn this in to a debate on healthcare systems, but I just can't let this go.  This isn't about "socialism" or other buzzwords, it's about taking care of our citizens.  I've worked in the healthcare field for over 20 years and my graduate degree is in healthcare administration.  I can't tell you how many people I've seen die in front of me over the years because they had no healthcare insurance (I can tell you it runs in the hundreds, and I'm just one provider).  We have an abysmal infant mortality rate compared to other "Western" nations.  Americans should be embarrassed that we have a healthcare system where your ability to live a healthy life is dependent on how much money you make.  The United States remains one of the few countries in the entire world that doesn't guarantee healthcare for its citizens.

Now, with that being said, Obamacare was and is not the answer.  It was a horribly cobbled together program that accomplishes very little.  I understand he needed to start somewhere, but he might as well have done nothing after what he came up with.  What he should have done is jack up everyone's income tax a few hundred dollars per year and then pay for the entire system.  That's how the rest of the world does it.  Btw, the Canadians who come over here for healthcare come for elective stuff, not life saving.  Every Canadian I've ever talked to (including ones I worked with in the healthcare field) have told me they love their system overall.  If you have an emergency, you're taken care of immediately.  The problem can come if you need something elective.  Want to get that nagging knee replacement?  You might be put in a queue for 6 months.  Still, I've never heard a single one of them that wants to go to the system we have.

As to Medicare, Doctors have been increasingly dropping Medicare patients for the past 20 years.  That's nothing new.  Private physicians are under no obligation to take Medicare, Medicaid, or patients with no insurance.  They never have been. 

[ML]

I don't want to turn this in to a debate on healthcare systems, but I just can't let this go.  I've worked in the healthcare field for over 20 years and my graduate degree is in healthcare administration.  I can't tell you how many people I've seen die in front of me over the years because they had no healthcare insurance (I can tell you it runs in the hundreds, and I'm just one provider).  We have an abysmal infant mortality rate compared to other "Western" nations.  Americans should be embarrassed that we have a healthcare system where your ability to live a healthy life is dependent on how much money you make.  We are one of the few countries in the entire world that doesn't provide for the healthcare needs of its citizens.

Now, with that being said, Obamacare was and is not the answer.  It was a horribly cobbled together program that accomplishes very little.  I understand he needed to start somewhere, but he might as well have done nothing after what he came up with.  What he should have done is jack up everyone's income tax a few hundred dollars per year and then pay for the entire system.  That's how the rest of the world does it.  Btw, the Canadians who come over here for healthcare come for elective stuff, not life saving.  Every Canadian I've ever talked to (including ones I worked with in the healthcare field) have told me they love their system overall.  If you have an emergency, you're taken care of immediately.  The problem can come if you need something elective.  Want to get that nagging knee replacement?  You might be put in a queue for 6 months.  Still, I've never heard a single one of them that wants to go to the system we have.

As to Medicare, Doctors have been increasingly dropping Medicare patients for the past 20 years.  That's nothing new.  Private physicians are under no obligation to take Medicare, Medicaid, or patients with no insurance.  They never have been.

Roy, you may have a lot of experience in the medical field, but you are not being objective here and are slanting and selectively using your experience to back up a political philosophy that you hold.

I know  for a fact that the poor people on welfare the states that I live in (have lived in) receive just as good medical care, if not better, than those who are working stiffs paying their own insurance or even paying out  of their own pocket.

People on welfare get a medical card which they hand through the window at the doctors office or hospital just the same as other folks hand their insurance card.

There are hospitals in every area that are required to take in and treat people regardless of whether or not they can pay, have insurance or not, etc.

[roykirk]

Roy, you may have a lot of experience in the medical field, but you are not being objective here and are slanting and selectively using your experience to back up a political philosophy that you hold.

I know  for a fact that the poor people on welfare the states that I live in (have lived in) receive just as good medical care, if not better, than those who are working stiffs paying their own insurance or even paying out  of their own pocket.

People on welfare get a medical card which they hand through the window at the doctors office or hospital just the same as other folks hand their insurance card.

There are hospitals in every area that are required to take in and treat people regardless of whether or not they can pay, have insurance or not, etc.

Emergency rooms are required to care for patients whether they have health insurance or not, but only in the ED.  That's a federal law.  Private clinics are not, nor is the hospital itself.  Private clinics are also not required to take Medicaid (welfare), and many of them (at least in our region) will not accept it.  What that results in is the "death loop," as we termed it.  People would go to the emergency room with various conditions (some of them quite serious) because that was the only place they could get a doctor to see them.  The ED would treat them to a basic level and then kick them loose with a few day of meds and orders to "follow up with your private doctor."  But since they didn't have a private doctor, they just got worse.  They'd continue this death loop for months and years until many of them simply died. 

But you're right, my experience has slanted my political philosophy.  Having a young vibrant adult die in my arms because they had an easily treatable cancer but couldn't get proper treatment is unacceptable to me.  Seeing a 12 year old girl die from untreated cystic fibrosis because both her parents made just a little too much money to get on Medicaid makes me embarrassed to be an American.  We have the best healthCARE in the world, I would argue that to my last day.  The problem is that it's only available to those who have the cash or a good health insurance policy. 

[ML]

Could be true regarding the ED.  However, people on welfare get the insurance card for full medical coverage.

Those you note who go  in cycles at the ED simply have not gone through the procedures to go on welfare and get the medical card.  Yes, I am sure  it is an unpleasant hassle to go through the procedures.  That is part of what encourages most people to try to stay gainfully employed.  When the procedures get too simple, as they are in many cases in many states, there are many more who apply for and receive welfare.

[roykirk]

Could be true regarding the ED.  However, people on welfare get the insurance card for full medical coverage.

Those you note who go  in cycles at the ED simply have not gone through the procedures to go on welfare and get the medical card.  Yes, I am sure  it is an unpleasant hassle to go through the procedures.  That is part of what encourages most people to try to stay gainfully employed.  When the procedures get too simple, as they are in many cases in many states, there are many more who apply for and receive welfare.

But the problem is that around here, most people can't qualify for Medicaid.  Most of the ones I've seen are gainfully employed, it's just in jobs that pay just high enough that they can't qualify for Medicaid and not anywhere near high enough for them to afford their own insurance. 

Not sure what the "welfare" full insurance card thing is you're talking about.  It could be that your state has a state sponsored Medicaid supplemental program or something that gives them more coverage.  Around here Medicaid is just Medicaid, there's no such thing as "full coverage" Medicaid.  Once you pull that card out around here, doors start getting slammed in your face. 

Believe me when I say I'm not arguing for Obamacare.  Like I said previously, I think it's an abomination that accomplishes nothing.  I'm just saying that keeping a death grip on our current system because it's somehow patriotic makes no sense.  The fact that our children have a better chance of surviving childhood in Cuba should tell us we need to find answers, and find them fast.

[ML]

  The fact that our children have a better chance of surviving childhood in Cuba should tell us we need to find answers, and find them fast.

Like so many things (and statistics) this may be true for the whole of USA, but break it down by demographics, and it certainly will not be true for the folks that post here and others like them.

So it gets right back to fact there are demographic groups in USA who simply do not care about and do not try to better themselves and their family (including the health aspects) through education, hard work, etc.

Like I posted in another thread . . . there are givers and takers.
Each year more people are moved into the takers category, and I am not talking about the aging population.  I am talking about 3rd, 4th and beyond generations of welfare takers.

I remember seeing a snippet on TV after the  Florida vote was counted.
A young man was bragging about his vote for Obama because he hoped the benefits for his family would continue.
Next a small business woman was interviewed who voted for Romney, and she noted how she would be paying for the benefits the young man and his family would be getting.

[Chicagoguy]

In my mind our system really needs help but there are so many lobby groups and politicians involved that we may never reach a consensus.
When my wife arrived here 3 years ago I began to look for an answer for us. I am retired and on Medicare so no help there. She basically has no necessary skills for a decent job with benefits and her English is still not good enough.
I was busy checking individual health policies and the worthwhile ones are very expensive. So with an agent we looked at just a policy with a very high [ $5000 ] deductable and that seemed a possibility. Especially since my last wife had died and her medical bill was $ 1,200,000. But it was ALL covered.
Then my wife piped up with an idea. "If I get that sick I will just go back home to Russia"  !!!   And we have been doing just that. Tickets can almost always be cheaper that treatments here.

[roykirk]

In my mind our system really needs help but there are so many lobby groups and politicians involved that we may never reach a consensus.
When my wife arrived here 3 years ago I began to look for an answer for us. I am retired and on Medicare so no help there. She basically has no necessary skills for a decent job with benefits and her English is still not good enough.
I was busy checking individual health policies and the worthwhile ones are very expensive. So with an agent we looked at just a policy with a very high [ $5000 ] deductable and that seemed a possibility. Especially since my last wife had died and her medical bill was $ 1,200,000. But it was ALL covered.
Then my wife piped up with an idea. "If I get that sick I will just go back home to Russia"  !!!   And we have been doing just that. Tickets can almost always be cheaper that treatments here.

Yeah, we have a Ukrainian neighbor do that who had lived here about 20 years.  He came down with prostate cancer and had to go back to Ukraine for a couple of months for treatment.  He seems fine now.