In-depth review of the non-military budget: Healthcare

This analytical note is part of a series of reviews of the non-military budget-2026 and is dedicated to expenditures on healthcare. General statistics on non-military budget expenditures are available via the link. We conducted this study with the support of the International Renaissance Foundation.

Healthcare remains one of the state’s key civilian priorities. Expenditures on healthcare rank fourth in terms of funding among all non-military areas of the state budget.

Main conclusion: the focus in healthcare should not be on the volume of funding, but rather on structural solutions and the allocation of funds within the system—strengthening primary care and preventive medicine, consolidating the network, ensuring competitive salaries, and establishing a capable National Health Service of Ukraine (NSZU). At the same time, cost savings in the healthcare sector should not be expected.

The healthcare system in Ukraine is underfunded

Each year, the government spends about 2.5% of GDP on public healthcare from the state budget, which covers only half of all necessary medical expenses; the population pays the rest.

Demand for medical services will grow along with the aging of the population

The most active consumers of healthcare services (“super-consumers”) are people aged 40 and older: on average, patients in these groups receive 7–9 healthcare services per year. Looking ahead to 2036, this very category of the population will continue to increase, which will determine future demand for healthcare.

Primary care requires systematic and long-term investment

The Medical Guarantees Program covers only two-thirds of primary care costs, while current rates do not reflect the actual cost of services.

Despite this underfunding, in 2026 the government launched a new program, Checkup 40+, with an annual budget of UAH 10bn — approximately one-third of the total primary care budget. However, this program partially duplicates the services provided by the Medical Guarantees Program, so it cannot be described as effective. Furthermore, the key barriers to preventive care are not financial but behavioral factors—such as the lack of a habit of getting regular checkups—which cannot be addressed solely through financial incentives.

We recommend revising the approach to promoting preventive care and directing funds toward systematically strengthening primary care.

Healthcare workers’ pay needs to be reviewed

Wages in the healthcare sector have traditionally been lower than the economy-wide average. The full-scale invasion has widened this gap, while also contributing to human resource outflows due to migration and mobilization.

We recommend reviewing the compensation standards for all sectors of the healthcare industry.

The consolidation of the healthcare network should continue while maintaining access to basic services

The excessively fragmented network of healthcare facilities disperses budgetary resources and prevents the improvement of service quality. The process of consolidating the hospital network has already begun; patients and funding are already being concentrated in more capable facilities.

We recommend continuing the consolidation of the hospital network, transferring complex and more expensive services to larger facilities, while simultaneously developing primary care, emergency care, and public transportation—services must remain within a reasonable distance.

It is necessary to strengthen the institutional capacity of the NSZU

Real wages at the NSZU have halved since 2021, while the agency remains understaffed. This affects its ability to enter into contracts, monitor their implementation, and analyze data. Without a fully functional NSZU, even a larger budget for the medical guarantees program will not yield better results.

We recommend increasing the NSZU’s payroll budget, accelerating staff recruitment, and reviewing qualification requirements and competency development within the institution (in particular through the NSZU Academy).