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Gaps in social protection for health care and long‐term care in Europe: Are the elderly faced with financial ruin?

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  • Xenia Scheil‐Adlung
  • Jacopo Bonan

Abstract

While public expenditure on health care and long‐term care (LTC) has been monitored for many years in European countries, far less attention has been paid to the financial consequences for older people of private out‐of‐pocket (OOP) expenditure necessary to access such care. Employing representative cross‐sectional data on the elderly populations of 11 European countries in 2004 from the Survey of Health, Ageing and Retirement in Europe (SHARE), we find that OOP payments for health care and LTC are very common among the elderly across European countries and such expenditures impact significantly on disposable income: up to 95 per cent of the elderly make OOP payments for health care and 5 per cent for LTC, resulting in income reductions of between 5 and 10 per cent, respectively. Failure to prevent financial ruin, as a consequence of excessive OOP payments, is evident in 0.7 per cent of elderly households utilizing health care and 0.5 per cent of elderly households utilizing LTC. Those particularly concerned are the poor, women and the very old.

Suggested Citation

  • Xenia Scheil‐Adlung & Jacopo Bonan, 2013. "Gaps in social protection for health care and long‐term care in Europe: Are the elderly faced with financial ruin?," International Social Security Review, John Wiley & Sons, vol. 66(1), pages 25-48, January.
    • Handle: RePEc:wly:intssr:v:66:y:2013:i:1:p:25-48
    DOI: 10.1111/issr.12001
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    Cited by:

    1. Aleksandra Kolasa & Ewa Weychert, 2022. "The causal effect of catastrophic health expenditure on poverty in Poland," Working Papers 2022-23, Faculty of Economic Sciences, University of Warsaw.
    2. Samuel López-López & Raúl del Pozo-Rubio & Marta Ortega-Ortega & Francisco Escribano-Sotos, 2021. "Catastrophic Household Expenditure Associated with Out-of-Pocket Healthcare Payments in Spain," IJERPH, MDPI, vol. 18(3), pages 1-18, January.
    3. Nikolaos Grigorakis & Christos Floros & Haritini Tsangari & Evangelos Tsoukatos, 2017. "Combined social and private health insurance versus catastrophic out of pocket payments for private hospital care in Greece," International Journal of Health Economics and Management, Springer, vol. 17(3), pages 261-287, September.
    4. Maria-Carmen García-Centeno & Román Mínguez-Salido & Raúl del Pozo-Rubio, 2021. "The Classification of Profiles of Financial Catastrophe Caused by Out-of-Pocket Payments: A Methodological Approach," Mathematics, MDPI, vol. 9(11), pages 1-20, May.
    5. Samuel López-López & Raúl Pozo-Rubio & Marta Ortega-Ortega & Francisco Escribano-Sotos, 2022. "Catastrophic household expenditure associated with out-of-pocket payments for dental healthcare in Spain," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(7), pages 1187-1201, September.
    6. Yerramilli, Pooja & Fernández, Óscar & Thomson, Sarah, 2018. "Financial protection in Europe: a systematic review of the literature and mapping of data availability," Health Policy, Elsevier, vol. 122(5), pages 493-508.

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