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Technically, any visitor is supposed to have an Ukrainian emergency care policy. In the past, this was likely included in the cost of your visa. Now, Americans can generally travel here without a visa.
My guess then is that most Americans traveling here do not have this emergency care policy. But I don't think the local authorities are losing any sleep since a typical visitor is likely to spend $50 or more a day here, and the economy needs that. Something serious like a heart attack? I don't know. But a little money under the table works miracles in this part of the world. Doctors here are generally well educated, at least the Soviet era doctors, but vastly underpaid.
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