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Chapter 9 | The impact of the crisis on the health system and health in Portugal 291 government expenditure decreased from 14.9% in 2008 to 13.5% in 2011; the broader social sector changed from 35.1% to 37.0% of the government budget during the same period (Statistics Portugal, 2013). Fig. 9.2 Total expenditure on health as a percentage of GDP, Portugal and EU average, 2000–2012 THE (% GDP) 12.0 10.0 8.0 6.0 4.0 2.0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 Note: THE: Total health expenditure. Source: WHO Regional Office for Europe, 2014. Portugal EU27 Fig. 9.3 Total expenditure on health per capita, Portugal and EU average, 2000–2012 THE per capita (US$ PPP) 3,500 3,000 2,500 2,000 1,500 1,000 500 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 Notes: THE: Total health expenditure. Source: WHO Regional Office for Europe, 2014. Portugal EU27 Fig. 9.4 Public expenditure on health as a share of total health expenditure, Portugal and EU average, 2000–2012 75 Public health expenditure (% THE) 70 65 60 55 Portugal EU27 50 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 Note: THE: Total health expenditure. Source: WHO Regional Office for Europe, 2014.
292 Economic crisis, health systems and health in Europe: country experience The private expenditure share of total health expenditure slightly increased from 35% in 2008 to 37.4% in 2012 (Table 9.3). Total private expenditure in 2011 came from OOP payments (29% of total spending), PHI (3%), private health subsystems (1.9%) and other sources 0.5% (Fig. 9.5). OOP payments increased from 28.5% of total health expenditure in 2008 to 28.9% in 2011 (Statistics Portugal, 2013; Fig. 9.5); this increase came prior to an increase in user charges introduced in 2012 (see section 3.2). Fig. 9.5 Breakdown of total health care expenditure by expenditure provider in Portugal, 2008–2011 2008 Non-profit-making organizations (other than social insurance) 0% Corporations (other than health insurance) 1% Other PHI (other than social insurance) 3% Private health subsystems 2% Social security funds 1% Other public institutions (other than social security funds) 6% Private household OOP payments 28% Public health subsystems 7% NHS 52% 2011 Non-profit-making organizations (other than social insurance) 0% Corporations (other than health insurance) 1% Source: OECD, 2012b Other PHI (other than social insurance) 3% Private health subsystems 2% Social security funds 1% Other public institutions (other than social security funds) 5% Private household OOP payments 29% Public health subsystems 4% NHS 55%
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292 Economic <strong>crisis</strong>, <strong>health</strong> <strong>systems</strong> <strong>and</strong> <strong>health</strong> in Europe: country experience<br />
The private expenditure share of total <strong>health</strong> expenditure slightly increased<br />
from 35% in 2008 to 37.4% in 2012 (Table 9.3). Total private expenditure in<br />
2011 came from OOP payments (29% of total spending), PHI (3%), private<br />
<strong>health</strong> sub<strong>systems</strong> (1.9%) <strong>and</strong> other sources 0.5% (Fig. 9.5). OOP payments<br />
increased from 28.5% of total <strong>health</strong> expenditure in 2008 to 28.9% in 2011<br />
(Statistics Portugal, 2013; Fig. 9.5); this increase came prior to an increase in<br />
user charges introduced in 2012 (see section 3.2).<br />
Fig. 9.5 Breakdown of total <strong>health</strong> care expenditure by expenditure provider in Portugal,<br />
2008–2011<br />
2008<br />
Non-profit-making organizations<br />
(other than social insurance)<br />
0%<br />
Corporations (other<br />
than <strong>health</strong> insurance)<br />
1%<br />
Other PHI (other than<br />
social insurance)<br />
3%<br />
Private <strong>health</strong> sub<strong>systems</strong><br />
2%<br />
Social security funds<br />
1%<br />
Other public institutions<br />
(other than social<br />
security funds)<br />
6%<br />
Private household<br />
OOP payments<br />
28%<br />
Public <strong>health</strong><br />
sub<strong>systems</strong><br />
7%<br />
NHS<br />
52%<br />
2011<br />
Non-profit-making organizations<br />
(other than social insurance)<br />
0%<br />
Corporations (other<br />
than <strong>health</strong> insurance)<br />
1%<br />
Source: OECD, 2012b<br />
Other PHI (other than<br />
social insurance)<br />
3%<br />
Private <strong>health</strong> sub<strong>systems</strong><br />
2%<br />
Social security funds<br />
1%<br />
Other public institutions<br />
(other than social<br />
security funds)<br />
5%<br />
Private household<br />
OOP payments<br />
29%<br />
Public <strong>health</strong><br />
sub<strong>systems</strong><br />
4%<br />
NHS<br />
55%
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