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.
Government expenditure accounts for 77% of total current healthcare expenditure. Non-government expenditure was financed by voluntary health contributions, which are predominantly private health insurance - 12% of the total - and the remaining 11% was paid for by household out-of-pocket payments. The share of spending between the classification groups had been stable over the time-series up to 2019, however the COVID-19 pandemic resulted in an increased share of spending by government. See Figure 4.1.
In 2018 and 2019 government spending was 74% of total current expenditure, since 2020 the proportion of total expenditure by government has been over 77%, this is largely due to the extra expenditure on preventive care as a result of the COVID-19 pandemic. While private health insurance payments for health care had been increasing year-on-year between 2018 and 2019, 2020 saw a significant decrease in spending by private health insurance companies due to the impact of the pandemic. As normal activity in the private healthcare sector resumed during 2021 the normal financing scheme expenditure pattern resumed its pre-pandemic trend. Household out-of-pocket expenditure increased by 21% over the period 2018 - 2022. See Figure 4.2 and Table 4.1.
| X-axis label | Government | Voluntary Payments | Household Out of Pocket |
|---|---|---|---|
| 2018 | 16628.1254991096 | 3107.64683595054 | 2724.68423986153 |
| 2019 | 17768.7356909942 | 3259.11173859674 | 2903.50088374997 |
| 2020 | 20683.3996938364 | 2924.86013478302 | 2897.22598173897 |
| 2021 | 22160.2369086679 | 3411.37573604546 | 3060.25502688299 |
| 2022 | 23967.6475668778 | 3708.76569742536 | 3306.98461233087 |
| Current Health Care Expenditure By Health Care Financing Scheme (% Change between 2018 to 2022) | |
| Government | 44 |
| Voluntary Health Care Payments | 19 |
| Household Out-of-Pocket | 21 |
Table 4.2 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 very small 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 4.2.
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