Web-economic-crisis-health-systems-and-health-web
Web-economic-crisis-health-systems-and-health-web Web-economic-crisis-health-systems-and-health-web
Montenegro Ratka Knežević Economic trends • After an above-average contraction of real per capita GDP in 2009, Montenegro experienced modest growth in 2010 and 2011. • The unemployment rate, already high prior to the crisis, remained well above the European mean through 2011. • Public per capita health expenditure decreased sharply in 2010 by 11.0%, while private expenditure growth accelerated. However, the increase in private expenditure was not large enough to offset the decrease in public expenditure (Montenegro: Fig. 1). • Montenegro Fig 2 gives the trends in per capita spending on health. Policy responses Changes to public funding for the health system • Since 2010, the Ministry of Finance has set a budget for health to control spending. • A planned decrease in the SHI contribution rate from 13.5% in 2007 to 9% of the gross salary of the employee in 2010 was scaled down to to 12.3% in 2010. • The SHI contribute rate for pensioners was cut from 19% to 1% (2010). • SHI spending fell in 2011 and in 2012 remained below the 2010 level. • The overall SHI contribution rate was increased from 32% to 33.8%, with the employer share falling from 14.5% to 9.8% and the employee share rising from 17.5% to 24% (2010). • Taxes on tobacco and tobacco products were increased (2011 and 2012). Changes to health coverage Population (entitlement) • No response reported. The benefits package • Coverage expanded for children and students under 26 years, patients with mental health problems and other chronic conditions (2008). • Access to publicly financed dental care expanded (2012).
446 Economic crisis, health systems and health in Europe: country experience % Montenegro: Fig. 1 Economic and fiscal indicators 2000–2007 and 2008–2011 60 55 50 45 40 35 30 25 20 15 10 5 0 −5 −10 −15 _ _ _ _ ● ● _ _ _ _ ● _ _ _ _ _ ● ● _ _ Real GDP per capita growth Deficit/surplus (% GDP) _ _ _ _ _ _ _ _ _ _ ● ● _ _ _ ● _ ● _ ● _ _ _ _ _ Government spending (% GDP) _ _ _ _ _ _ _ _ _ _ ● ● ● ● ● _ _ _ _ _ Government health spending (% total government spending) Notes: Deficit/surplus: World Bank; Other indicators: WHO Health for All. 10−year bond rates Year 2000−2007 2008 2009 2010 2011 _ _ _ ● ● ● _ ● _ _ _ _ ● _ _ _ _ _ _ Unemployment rate Montenegro: Fig. 2 Trends in per capita spending on health, 2000–2011 Public spending per capita OOP spending per capita Non−OOP private spending per capita 750 Per capita spending $, PPP 500 250 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 20 Growth % 10 0 −10 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 Public spending per capita growth OOP spending per capita growth Note: Spending calculated from WHO Health for All. Non−OOP private spending per capita growth
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446 Economic <strong>crisis</strong>, <strong>health</strong> <strong>systems</strong> <strong>and</strong> <strong>health</strong> in Europe: country experience<br />
%<br />
Montenegro: Fig. 1 Economic <strong>and</strong> fiscal indicators 2000–2007 <strong>and</strong> 2008–2011<br />
60<br />
55<br />
50<br />
45<br />
40<br />
35<br />
30<br />
25<br />
20<br />
15<br />
10<br />
5<br />
0<br />
−5<br />
−10<br />
−15<br />
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Real GDP<br />
per capita growth<br />
Deficit/surplus<br />
(% GDP)<br />
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Government<br />
spending<br />
(% GDP)<br />
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_ _ _<br />
● ● ● ● ●<br />
_ _ _ _ _<br />
Government<br />
<strong>health</strong> spending<br />
(% total government<br />
spending)<br />
Notes: Deficit/surplus: World Bank; Other indicators: WHO Health for All.<br />
10−year<br />
bond rates<br />
Year<br />
2000−2007 2008 2009 2010 2011<br />
_ _ _ ● ●<br />
●<br />
_ ●<br />
_ _ _<br />
_ ●<br />
_ _ _ _<br />
_<br />
_<br />
Unemployment<br />
rate<br />
Montenegro: Fig. 2 Trends in per capita spending on <strong>health</strong>, 2000–2011<br />
Public spending per capita OOP spending per capita Non−OOP private spending per capita<br />
750<br />
Per capita spending $, PPP<br />
500<br />
250<br />
0<br />
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011<br />
20<br />
Growth %<br />
10<br />
0<br />
−10<br />
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011<br />
Public spending<br />
per capita growth<br />
OOP spending<br />
per capita growth<br />
Note: Spending calculated from WHO Health for All.<br />
Non−OOP private spending<br />
per capita growth
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