The constitutional bases for Ukraine's health policy partly explain the country's poor health outcomes. The constitution - and particular article 49 - contain self-contradictory provisions that run right through the rest of Ukraine's health laws. The constitution gives citizens and others the right to free health care, and burdens the government with many ancillary obligations related to health policy. Yet, nothing in Ukraine's law - or its constitutional jurisprudence so far - has limited that right. Since the founding of the new republic, lawmakers have struggled with their understanding of such a right.

The first contradiction - everyone has the right to health protection, with state funding serving as the mechanism for providing such a right. The second contradiction - the state must basically provide for effective and accessible medical service. The third contradiction - if everyone has the right to medical insurance, and if the state must provide health care for free, it, therefore, follows that the state must provide such insurance for free (which it does not). The fourth contradiction - the state must provide conditions for effective, accessible medical service and promote the development of privately owned medical institutions, partly through funding socio-economic programs and physical culture and sports. Yet, how can state-funding help the development of privately owned institutions and the larger development of a market system?

This article describes the jurisprudence of constitutional law in the health sector for a developing market economy - and shows just how a seemingly innocuous provision, nestled deep in its constitution, could reverberate into the wider economy-building arena. The authors argue that the constitutional provision on free health care needs amendments as it does not reflect neither the reality nor the goal of the health care reform (the goal of the reform is the transition to the state solidarity health insurance system).