The WHO Barcelona Office at Sant Pau has published a report on the eve of the Universal Health Coverage Day. The report brings together data from 24 countries in Europe on unmet need and financial hardship to assess whether people can afford to pay for health care.
Monitoring financial protection is one of the key aspects of the office’s work to evaluate regional and country progress towards meeting the goal of universal health coverage. The publication Can people afford to pay health care? New evidence on financial protection in Europe (2019) shows that financial hardship varies widely in Europe, and that there is room for improvement even in high-income countries that provide the whole population with access to publicly financed health services.
One of the report’s conclusions is that catastrophic health spending is heavily concentrated among the poorest households in all of the countries in the study. Where financial protection is relatively weak, catastrophic spending is mainly driven by out-of-pocket payments for outpatient medicines.
Health systems with strong financial protection and low levels of unmet need share the features described below. There are no large gaps in health coverage. Coverage policy is carefully designed to minimize access barriers and out-of-pocket payments, particularly for poor people and regular users of health services. Public spending on health is high enough to ensure relatively timely access to a broad range of health services without informal payments. Finally, as a result of these initiatives, out-of-pocket payments are low, accounting for less than or close to 15% of current spending on health.
Gaps in coverage arise from weaknesses in the design of three policy areas: population entitlement, the benefits package and user charges (co-payments). The report summarizes actions that can reduce unmet need and financial hardship by strengthening coverage policy. It also highlights actions that should be avoided.
For more information, please download the full report in English.