Can people afford to pay for health care? New evidence on financial protection in Estonia

ABSTRACT

The incidence of catastrophic spending on health is higher in Estonia than in many European Union countries, but lower than in Latvia and Lithuania. Catastrophic spending, primarily due to medicines, affects the poorest households the most. Estonia’s relatively high incidence of catastrophic spending on health partly reflects a level of public spending on health that is well below the European Union average and slightly lower than Estonia can afford. It also reflects substantial gaps in all three dimensions of health coverage population coverage, service coverage and user charges. Gaps in coverage not only lead to financial hardship but also create barriers to access. Growing unmet need – and rising inequalities in unmet need – are significant problems in Estonia. Addressing high levels of unmet need and, at the same time, improving financial protection will require additional public investment in the health system. It will also require attention to the design of coverage policy. This review is part of a series of country-based studies generating new evidence on financial protection in European health systems.