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Private health expenditure in Ireland: Assessing the affordability of private financing of health care

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  • Johnston, Bridget M.
  • Burke, Sara
  • Barry, Sarah
  • Normand, Charles
  • Ní Fhallúin, Maebh
  • Thomas, Steve

Abstract

This paper investigates the affordability of private health expenditure among Irish households and the services contributing towards financial hardship. We use data from the Irish Household Budget Survey, a representative survey of household spending in Ireland, covering 2009-10 and 2015-16. Private health expenditure comprises out-of-pocket payments for health and social care services and private health insurance (PHI) premiums. The poverty threshold is 60% of median total equivalised consumption and households with consumption below this level were defined as poor. Households were classified as having unaffordable health expenditure if: 1) they were poor and reported any spending; 2) they were pushed below poverty threshold by health spending; or 3) their spending on health exceeded 40% of capacity to pay. Despite signs of economic recovery, the incidence of unaffordable private health spending increased over the years—from 15% in 2009-10 to 18.8% in 2015-16. People on low incomes were disproportionately affected. The largest component of unaffordable spending for poorer households is PHI and not user charges, which have actually fallen as a cause of hardship. Our findings indicate that reliance on private health expenditure as a funding mechanism undermines the fundamental goals of equity and appropriate access within the health care system.

Suggested Citation

  • Johnston, Bridget M. & Burke, Sara & Barry, Sarah & Normand, Charles & Ní Fhallúin, Maebh & Thomas, Steve, 2019. "Private health expenditure in Ireland: Assessing the affordability of private financing of health care," Health Policy, Elsevier, vol. 123(10), pages 963-969.
    • Handle: RePEc:eee:hepoli:v:123:y:2019:i:10:p:963-969
    DOI: 10.1016/j.healthpol.2019.08.002
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    Cited by:

    1. Keane, Claire & Regan, Mark & Walsh, Brendan, 2021. "Failure to take-up public healthcare entitlements: Evidence from the Medical Card system in Ireland," Social Science & Medicine, Elsevier, vol. 281(C).
    2. Connolly, Sheelah & Wren, Maev-Ann, 2023. "Towards universal healthcare in Ireland – what can we learn from the literature?," Research Series, Economic and Social Research Institute (ESRI), number SUSTAT121, June.
    3. Thomas, Steve & Johnston, Bridget & Barry, Sarah & Siersbaek, Rikke & Burke, Sara, 2021. "Sláintecare implementation status in 2020: Limited progress with entitlement expansion," Health Policy, Elsevier, vol. 125(3), pages 277-283.

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