Can people afford to pay for health care? New evidence on financial protection in Montenegro

Overview

This review is part of a series of country-based studies generating new evidence on financial protection – affordable access to health care – in European health systems. Financial protection is central to universal health coverage and a core dimension of health system performance. Catastrophic health spending is higher in Montenegro than in most European Union countries. It is heavily concentrated in the poorest fifth of the population and in households headed by unemployed people, other economically inactive people and older people; and largely driven by out-of-pocket spending on outpatient medicines. These findings reflect the health system’s heavy reliance on out-of-pocket payments, gaps in health coverage, the complexity of coverage policy and weaknesses in the coverage, purchasing and supply of medicines. Building on recent steps to address some gaps in coverage, further efforts to strengthen financial protection should focus on reducing out-of-pocket payments for people with low incomes or chronic conditions; improving the coverage and regulation of outpatient medicines; improving data collection and monitoring; and ensuring that public spending on health grows in line with population health needs and national income.