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3. Financing
Chapter summary
•
The Portuguese health system draws on a mix of public and private
financing.
•
The NHS is predominantly financed through general taxation.
•
The health subsystems, which provide comprehensive or partial health
care coverage to between one fifth and one quarter of the population,
are financed mainly through employee and employer contributions.
•
Private VHI covers about 26% of the population, and it mainly has a
supplementary role.
•
Total health expenditure represented 9.5% of the country’s GDP in 2014.
•
Around 35% of total health expenditure, is private, mainly in the form
of out-of-pocket payments (both co-payments and direct payments
by patients), and to a lesser extent in the form of premiums to private
insurance schemes and mutual institutions.
•
While user charges exist for consultations, emergency visits, home visits,
diagnostic tests and therapeutic procedures, around 60% of the population
is exempted from paying them.
•
The Ministry of Health receives a global budget for the NHS from the
Ministry of Finance, which is then allocated to the several institutions
within the NHS.
•
The Ministry of Health allocates funds to the health regions, based on
a combination of historical expenditure and capitation, which pay for
primary care and specific health programmes.
•
Public hospitals are funded through global budgets, but with an increasing
role of diagnosis-related groups (DRGs), and private insurers and health
subsystems pay providers.
3. Financing