Web-economic-crisis-health-systems-and-health-web
Web-economic-crisis-health-systems-and-health-web Web-economic-crisis-health-systems-and-health-web
Country profiles of health system responses to the crisis | Portugal 461 % Portugal: 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 −20 −25 −30 _ _ _ _ ● ● _ _ ● ● _ _ _ ● _ Real GDP per capita growth _ _ _ _ _ ● ● _ _ ● ● ● _ _ _ Deficit/surplus (% GDP) _ _ _ _ _ _ _ _ _ _ ● ● _ _ _ ● _ ● _ ● _ _ _ _ _ Government spending (% GDP) _ _ _ _ _ ● ● ● ● ● _ _ _ _ _ Government health spending (% total government spending) _ _ _ _ _ _ ● _ ● ● ● ● _ _ _ 10−year bond rates _ _ _ _ _ _ _ ● ● ● ● ● _ _ _ _ _ Unemployment rate Notes: Deficit/surplus: Eurostat; 10-year bond rates: European Central Bank; Other indicators: WHO Health for All. Year 2000−2007 2008 2009 2010 2011 Portugal: 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 1500 Per capita spending $, PPP 1000 500 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 10 Growth % 5 0 −5 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
462 Economic crisis, health systems and health in Europe: country experience • The cost to all levels of government of ADSE and the other subfunds (for the armed forces and for the police service) was reduced by 30% in 2012 and by a further 20% in 2013, with these subsystem funds becoming self-financing by 2016. • Government costs to be reduced by lowering the employer contribution rate to 1.25% in 2013 and by adjusting the scope of health benefits. Changes to health coverage Population (entitlement) • The ADSE was made optional for all civil servants (2011). The benefits package • Plans to introduce a minimum benefits package (MoU 2011). User charges • Introduction of user charges for antidepressants, antipsychotic drugs and other drugs associated with the treatment of serious mental illnesses such as schizophrenia, dementia, autism and bipolar disorder; a 5–10% coinsurance was officially opposed by the Order of Medical Doctors (2010). • Introduction of an exemption from user charges for people registered as unemployed and their dependants (2011). • Exemption from all user charges extended to children aged 12 years or younger, pregnant women, transplant recipients, people with a disability status of over 60%, military and ex-military (the latter with permanent disability) and fire service workers (2011). • Exemption from primary care user charges extended to fire service workers; active blood donors; people who donate cells, tissue or organs; people with chronic conditions; and public health services (2011). • Introduction of user charges for over-the-counter drugs such as paracetamol, antacids and antiviral drugs (2011). • User charges increased for vaccines for yellow fever, Japanese encephalitis, typhoid, meningitis and rabies tetravalent (from under €1 to €50–100 per vaccine), medical certificates (from under €1 to €20), statements certifying incapacity (from under €1 to €50) and statements certifying disability required by disabled people for access to fiscal benefits (from under €1 to €100) (2011).
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Country profiles of <strong>health</strong> system responses to the <strong>crisis</strong> | Portugal<br />
461<br />
%<br />
Portugal: 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 />
−20<br />
−25<br />
−30<br />
_ _<br />
_ _<br />
● ●<br />
_ _<br />
●<br />
●<br />
_ _<br />
_<br />
●<br />
_<br />
Real GDP<br />
per capita growth<br />
_ _<br />
_ _ _<br />
● ●<br />
_ _<br />
●<br />
● ●<br />
_ _ _<br />
Deficit/surplus<br />
(% GDP)<br />
_ _ _ _ _ _ _ _<br />
_ _<br />
●<br />
●<br />
_ _<br />
_<br />
● _ ●<br />
_<br />
●<br />
_ _ _ _ _<br />
Government<br />
spending<br />
(% GDP)<br />
_ _ _ _ _<br />
● ● ● ● ●<br />
_ _ _ _ _<br />
Government<br />
<strong>health</strong> spending<br />
(% total government<br />
spending)<br />
_ _ _ _ _<br />
_ ● _ ●<br />
●<br />
●<br />
●<br />
_ _ _<br />
10−year<br />
bond rates<br />
_ _ _ _ _<br />
_ _<br />
●<br />
●<br />
●<br />
●<br />
●<br />
_ _ _ _ _<br />
Unemployment<br />
rate<br />
Notes: Deficit/surplus: Eurostat; 10-year bond rates: European Central Bank; Other indicators:<br />
WHO Health for All.<br />
Year<br />
2000−2007 2008 2009 2010 2011<br />
Portugal: 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 />
1500<br />
Per capita spending $, PPP<br />
1000<br />
500<br />
0<br />
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011<br />
10<br />
Growth %<br />
5<br />
0<br />
−5<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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