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

Lithuania
Gintaras Kacevičius and Skirmante Sauliune
Economic trends
• Lithuania's real per capita GDP contracted sharply in 2009 by 13.4%
but recovered the following year.
• The unemployment rate increased and remained above the European
mean even after the economic recovery.
• The cost of borrowing increased substantially in 2009 but 10-year bond
rates returned to mean European levels by the following year.
• Despite an increase in the size of government spending relative to GDP
in 2009, health spending has remained constant as a share of government
spending, close to the European mean. OOP expenditure per capita
declined slightly in 2009 by 3.4% but in 2011 increased by 10.0%
(Lithuania: Figs 1 and 2).
Policy responses
Changes to public funding for the health system
• The state budget for health, including contributions to SHI, increased
between 2008 and 2011; health was the only public sector to receive
increased funding in 2009.
• In comparison to 2008, SHI revenues fell by 20% in 2009 and by further
23% in 2010 as a result of higher unemployment and lower salaries, but
began to rise again from 2011; SHI spending fell by 5% between 2008
and 2010 but recovered in 2011.
• A tax reform was introduced to separate SHI contributions from personal
income tax (2009); the SHI contribution was set at 9% of gross earnings or
income for employees and some groups of self-employed people and 9% of the
official minimum monthly salary for the rest self-employed and other groups;
collection agents (the Social Insurance Fund and the State Tax Office) were
forced to increase their effectiveness in enforcing payment of contributions or
face penalties; the overall social security contribution rate was increased from
26% in 2006 to 35% in 2012.