Health Systems in Transition - Portugal

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Health systems in transition Portugal 70
Between 2009 and 2014, both costs and revenues from ADSE were reduced,
with costs declining more significantly than revenues. During that period, public
funding of the ADSE was reduced, whereas contributions from beneficiaries
increased to 3.5% to make the subsystem self-financed. This suppression of
public funding to the ADSE was only possible because the Ministry of Health
absorbed costs of health care provided to ADSE beneficiaries in the NHS. In
2015, ADSE achieved a surplus of €137 million (ERS, 2016c).
Comparing contributions of 3.5% to the ADSE with the salary of
beneficiaries, and average contributions to VHI, regarding different profiles of
insured individuals, the ADSE stands out as more advantageous, particularly
to married couples with children. VHI might be more advantageous to young
single individuals with no children. However, as the annual salary of an
individual increases, contributions to the ADSE surpass those to VHI. For
instance, from a monthly wage of €3154.7, VHI is more advantageous than
the ADSE for a young 35-year-old couple with a 5-year-old child. In contrast,
a 45-year-old couple with 12- and 17-year-old children, VHI will only be
advantageous for a monthly wage higher than €6536.9 (ERS, 2015c).
3.6.2 External sources of funds
In the context of Europe 2020 – the EU’s growth strategy for the coming decade –
Portugal and the European Commission have signed a Partnership Agreement,
named Portugal 2020, which includes five structural and investment European
Funds to support economic and social development policies for the period
2014–2020. Applications to funding on different areas are centrally managed
at Balcão 20203. Applications in the health sector include support to patients at
home or in the community through the use of technology, health care workers
training, and awareness and support to social and health services reform.
Additionally, the Third Health Programme 2014–2020 was approved in 2014
(Regulation No. 282/2014 of the European Parliament and Council, of 11 March
2014) and is executed through annual work plans, which establish priority
actions and financial resources for each year. The Programme is managed by
the European Commission with assistance from the Consumers, Health and
Food Executive Agency (CHAFEA).
With a total of €449.4 million for the period 2014–2020, the Third Health
Programme aims to support and complement Member States’ action in areas
where cooperation at EU level is either indispensable or provides important
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