Portugal ponders NHS insurance model

The President of the Council of Public Finances, Nazaré da Costa Cabral has suggested the National Health System (SNS) could be financed by an Ireland-style ‘social insurance’ scheme.

It would represent a totally different model of financing the cash-strapped service with health care cover.
According to ECO online, Nazaré da Costa Cabral (CFP) says that one of the main risks for the survival of the SNS has to do with the model of financing.
“The situation in which the SNS now finds itself is serious and there’s hardly a day when it does’t make the headlines, or in which statements are not made by the main agents in the sector, including politicians,” she said.
“The SNS seems to be under assault from all sides and propelled towards the door, as though it were lost in a labyrinth”, says the economist.
Most of the SNS financing comes from revenues from the State Budget, while the share of other sources of funding such as moderating taxes have “considerably reduced over time” according to a report “The Performance Evolution of the National Health Service, SNS, in 2021’ which the CFP published at the beginning of June.
Nazaré da Costa Cabral regrets that there has never been a discussion about diversifying sources of SNS funding, either by contributions or insurance. Even complimentary options of funding have been rejected”, she says.
Nazaré Costa Cabral therefore suggests creating a social insurance to cover health care as is the case with sickness insurance in the social security system which covers the risk of “temporary incapacity to work”.
Nazaré Costa Cabral reflects on some other points for the future of the system in the report. The financial pressure on the SNS and ‘security valves’, problems reorganising the SNS, and structural problems all needing to be resolved.
One possibility that the government could explore is the Irish model. Ireland has a dual healthcare system, consisting of both private and public healthcare options. The public healthcare system is regulated by the Irish government’s Health Service Executive (HSE). Ireland’s health budget for 2021 was €21 billion. Portugal’s healthcare budget was €15Bn.