System of Health Accounts 2024

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.

More than three-quarters of healthcare expenditure is financed by government

Government expenditure accounts for 78% 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 10% was paid for by household out-of-pocket payments. The share of spending between the classification groups had been stable over the five years since 2020. See Figure 4.1.

Over last five years government spending on healthcare has increased by 36%, in the same period there was a 53% increase in expenditure by private health insurance schemes. See Figure 4.2 and Table 4.1.

Where do the Financing Schemes source their revenue?

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.