The financing of health care in insurance systems and the sustainability of public finances

Purpose – The purpose of the paper is to examine the relationship between the organisation of the state (determined by selected characteristics, i.e. the organisational structure model and the position of the SNG sector) and the organisation of the health care system, and an indication of the possible consequences for the sustainability of public finance. Research method – The author uses a method of descriptive analysis and the analysis of statistical data on health care expenditure in 12 EU Member States with an insurance model of health care. The quantitative analysis was based on the latest available statistical data (2017) from the OECD, the WHO and Eurostat databases (according to ICHA and SHA2011). Results – It was concluded that despite the legal separation and theoretical independence from the budget system, the insurance model of health care may pose a threat to the sustainability of public finance. This applies both to the state budget and the SNG sector, which is particularly vulnerable in countries where the decentralisation of public services is not accompanied by an appropriate design of the financing system. Originality /value / implications /recommendations – This paper discusses the problem of the compatibility of the health care system and state organisation, omitted in literature, including the position of the SNG sector, in the context of fiscal sustainability.