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

Overview

This review is part of a series of country-based studies generating new evidence on affordable access to health care (‎financial protection)‎ in health systems in Europe. Financial protection is central to universal health coverage and a core dimension of health system performance. Catastrophic health spending is lower in Slovakia than in many European Union countries (‎particularly those in central Europe)‎ but has increased in recent years. It is almost entirely concentrated in the poorest consumption quintile and in households headed by older people, employed people or pensioners and mainly driven by outpatient medicines in households with low incomes. Despite Slovakia’s relatively comprehensive publicly financed benefits package and the presence of mechanisms to protect people from user charges (‎co-payments)‎, gaps in coverage persist. The system of copayments for outpatient prescribed medicines is complex and exemptions from and caps on co-payments for outpatient prescribed medicines and medical products do not apply to most working-aged people with low incomes; coverage of dental care is limited and many dentists do not offer covered services or materials; and people who fail to pay mandatory social health insurance contributions, as well as unemployed asylum seekers, homeless people and undocumented migrants have very limited access to publicly financed health care. The Government can reduce unmet need and financial hardship in households with low incomes by ensuring that people can always access outpatient prescribed medicines without copayments, improving the mechanisms used to protect people from copayments, expanding access to publicly financed dental care and tackling inefficiencies in the health system that push people to pay out of pocket for covered care.