ESS Paper N 31.doc
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• Severity of OOP The impact of OOP for LTC on households’ income is more severe than that for OOP on
health care. Levels of expenditure are particularly high, ranging from between 10 to 20 per cent of households’ income in the Nordic countries – but also in Greece, Italy and Spain.
On average, across the countries observed, households spend 9.6 per cent of their income on OOP expenditure for LTC, while this only accounts for 2.5 per cent for health care
figure 12.
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2 4
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10 12
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15 20
25 30
Switzerl … Germany
France Netherla…
Austria Belgium
Sweden Denmark
Greece Italy
Spain
OOP as a share of household income
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ESS Paper N 31.doc
3.2.3. Excessive out-of-pocket payments for health and LTC
OOP expenditures for health and LTC can even exceed 100 per cent of household income.
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This is due either to a household’s very low income or extremely high OOP expenditures. These payments, which are the result of serious gaps in financial protection,
concern on average around 1 per cent of elderly households paying OOP for health care and 0.5 percent paying for LTC figure 13.
Households paying more than 100 per cent of their income on health care are unevenly distributed across Europe. While in Austria, Greece and Italy more than 1 per cent of the
households with at least one member aged over 50 years are concerned with this problem, the level does not exceed 0.5 per cent of total households in the rest of Europe.
Except for the Netherlands, more households are burdened by excessive health care expenditure than by LTC expenditure. OOP expenditures on LTC impact on less than 0.3
per cent of households in many European countries Belgium, Denmark, France, Germany, Netherlands, Sweden and Switzerland, whereas they exceed 1 per cent in households in
Italy and Greece, corresponding to about 220,000 households for health care and 170,000 households for LTC in Italy, and 50,000 for health care and 29,000 for LTC in Greece.
Despite the relatively low number, these cases constitute a severe threat for those concerned and raise concerns regarding human rights for health and social security and the
principle of equity.
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Note: income does not include private transfers from the family and any consideration on wealth or saving. This sub-sample will not be included in the following analysis; averages may therefore be
underestimated.
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1.5 2
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Health care LTC
