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Health systems in transition
Portugal
54
Since 2010, the amount spent on health care has decreased in both absolute
and relative terms, after a strong growth pattern observed in the previous years
(Table 3.1). The Economic and Financial Adjustment Programme required
public expenditure for health to be cut, while some part of those cuts targeted
the private sector. In the European context, public sources of spending as a
percentage of total health expenditure in Portugal (64.7%) are among the lowest
in the EU, where the average is 76.0% (Fig. 3.4).
Most private health expenditure is accounted for by out-of-pocket (OOP)
spending, in the form of co-payments and direct payments made by citizens
for pharmaceuticals, examinations and outpatient consultations (Table 3.2).
OOP payments in Portugal are estimated to be among the highest in the EU,
accounting for 27.6% of total health expenditure in 2015 (INE, 2016f) (see
section 3.4). Health care financing in Portugal is overall slightly regressive due
to the high share of OOP payments along with a heavy reliance on indirect taxes.
Indirect taxes on goods and services accounted for 42.3% of total government
revenue in 2015, whereas the EU average is 34.7% (INE, 2016e).
Table 3.2
Expenditure on health (as % of total health expenditure) according to function and
type of financing, 2014
Curative and
rehabilitation
care
Long-
term
care
Ancillary
services
Medical
goods
Preventive
care
Admin-
istration
Other
services
Total
General
government
48.3
1.8
4.7
9.5
0.8
0.9
0.1
66.2
Private sector
17.8
0.5
3.3
10.1
1.0
1.1
0.0
33.8
Private
out-of-pocket
14.8
0.4
2.5
9.6
0.1
0.0
0.0
27.5
Private
insurance
3.0
0.0
0.9
0.4
0.0
1.1
0.0
5.4
Corporations
(other than
health
insurance)
0.0
0.0
0.0
0.0
0.8
0.0
0.0
0.8
Other (e.g.
non-profit
institutions
serving
households)
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
Total expenditure
66.1
2.4
8.1
19.6
1.8
2.0
0.1
100.0
Source
: OECD, 2016a.