Web-economic-crisis-health-systems-and-health-web

Latvia
Uldis Mitenbergs and Maris Taube
Economic trends
• Latvia's real per capita GDP contracted sharply in 2009 and stagnated in
2010, although it made a strong recovery in 2011.
• The unemployment rate, which had been near the European mean, more
than doubled in 2009 to 16.9% and had not recovered by 2011.
• Ten-year bond rates increased dramatically in 2009, although by 2011
they had returned to the European mean.
• The size of government expenditure relative to GDP increased in 2008
and 2009 but decreased in 2011; health spending as a share of government
spending has remained constant throughout the crisis. Per capita health
spending decreased in 2009 for all sources of financing. In 2011, public
per capita spending declined by 2.3% while private sources of funding
had positive growth (Latvia: Fig. 1).
• Latvia Fig 2 gives the trends in per capita spending on health.
Policy responses
Changes to public funding for the health system
• The Ministry of Health's budget fell by 12.6% in 2009, remained
stable from 2010 to 2012 and was expected to be cut substantially (to
2.9% of GDP) in 2013 (since 2011, the Ministry of Health budget no
longer includes EU funds for health care institutions not under its direct
supervision, which have been moved to the Ministry of Finance).
• Social insurance tax increased from 33.09% to 35.09% (2011).
• Taxes on alcohol and tobacco increased (these taxes are not earmarked for
health) (2009).
Population (entitlement)
• The Ministry of Health plans to change the basis for entitlement from
residence to insurance status (2012).
The benefits package
• Home care added to the benefits package (2009).