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System of Health Accounts 2019

Financing Schemes of Health Care Services

Financing schemes of Health Care Services

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Who pays for Health Care?

Financing schemes for health care are the arrangements through which people pay for and obtain health services. There are three main categories of financing scheme: Government & compulsory schemes (HF.1), Voluntary health care schemes (HF.2) and Direct payments by households or Household out-of-pocket (HF.3). Further details are available in the background notes.

Three-quarters of healthcare expenditure is financed by government
Government expenditure accounts for 74% of total current healthcare expenditure. Non-government expenditure was financed by voluntary health contributions, which are predominantly private health insurance, - 14% of the total - and the remaining 12% was paid for by household out-of-pocket payments. The share of spending between the classification groups has been stable over the time-series (see Figure 3.1).

Between 2015 and 2019 there was an increase of 28% in health spending by government. Private health insurance payments for health care grew by 14% and household out-of-pocket expenditure increased by 10% over this period, (see Figure 3.2 and Table 3.1).

X-axis label	Government	Voluntary Payments	Household Out of Pocket
2015	13847.6715546834	2841.82560244328	2540.9780519521
2016	14622.3084753574	2912.31762467983	2572.6993518234
2017	15485.6303326378	3058.2039959028	2675.42543800744
2018	16627.8149355418	3107.10100174578	2696.89130218914
2019	17735.9817901652	3259.63051107023	2786.17032932532

	Current Health Care Expenditure By Health Care Financing Scheme (% Change between 2015 to 2019)
Government	28.0762564991335
Voluntary Health Care Payments	14.7079521463758
Household Out-of-Pocket	9.64187327823691

Table 3.1: Current Health Care Expenditure by Financing Scheme, 2015 to 2019

Where do the Financing Schemes source their revenue?

Table 3.2 shows the revenues of financing schemes for health care. See the Background Notes for more information on this classification.

Most of the revenue for the government expenditure on health care came through internal government transfers, i.e. general taxation. Social insurance contributions (such as PSRI) cover a tiny percentage of government spending on health care (1%). The revenues for Voluntary Health Contributions are predominantly voluntary prepayments, i.e. health insurance premiums, (see Table 3.2).

Table 3.2 : Revenues of Health Care Financing Schemes, 2019

Next Chapter >> Expenditure by Providers of Health Care

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Table 3.1: Current Health Care Expenditure by Financing Scheme, 2015 to 2019
								€ million	% of total	% change
ICHA-HF Code				2015	2016	2017	2018	2019	2019	2015-2019
HF.1		Govt Financing Schemes and Compulsory Contributory Health Care Financing Schemes		13,848	14,622	15,486	16,628	17,736	75	28
	HF.1.1		Government	13,788	14,558	15,408	16,491	17,591	74	28
	HF.1.2		Compulsory Contributory Health Insurance	60	64	78	137	145	1	142

HF.2		Voluntary Health Care Payment Schemes		2,842	2,912	3,058	3,107	3,260	14	15
	HF.2.1		Voluntary Health Insurance	2,465	2,519	2,640	2,675	2,800	12	14
	HF.2.x		Other Voluntary Care Payment	377	393	418	432	460	2	22

HF.3		Household Out-of-Pocket Payments		2,541	2,573	2,675	2,697	2,786	12	10

		Total		19,230	20,107	21,219	22,432	23,782	100	24

Table 3.2 : Current Health Care Expenditure by Revenues of Financing Schemes, 2019
								€ million
ICHA-FS Code	Govt and compulsory contributory health care financing	Government	Compulsory contributory health insurance	Voluntary health care payment	Voluntary health insurance	NPISH financing	Household out-of-pocket payment	Total
	HF.1	HF.1.1	HF.1.2/1.3	HF.2	HF.2.1	HF.2.x	HF.3
FS.1 Transfers from Government domestic revenue	17,591	17,591						17,591
FS.1.1 Internal transfers and grant	17,591	17,591						17,591

FS.3 Social Insurance contributions	145		145					145
FS.3.1 From employees	32		32					32
FS.3.2 From employers	105		105					105
FS.3.3 From self-employed	8		8					8

FS.5 Voluntary Prepayment				2,800	2,800			2,800

FS.6 Other domestic Revenues n.e.c.				460		460	2,786	3,246
FS.6.1 Other revenues from households							2,786	2,786
FS.6.x Other revenues from corporations				460		460		460

Total:	17,736	17,591	145	3,260	2,800	460	2,786	23,782

System of Health Accounts 2019

Financing Schemes of Health Care Services

Financing schemes of Health Care Services

Who pays for Health Care?

Where do the Financing Schemes source their revenue?

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