Latvia HiT (2019)

The European Observatory on Health Systems and Policies has released a new health system review (HiT) for Latvia with a special focus on the developments and health system reforms since 2012.

Life expectancy has increased, but it is still well below the EU average, with a substantial gender gap

While life expectancy at birth has increased from 70.2 years in 2000 to 74.9 years in 2017, there is a substantial gender gap, with women expected to live about 10 years longer than men. Main causes of death include diseases of the circulatory system, malignant neoplasms, and external causes. The burden of mortality and morbidity in Latvia is heavily influenced by a high prevalence of behavioural risk factors.

Public spending is low, while out-of-pocket payments are among the highest in Europe

Despite near universal population coverage, the benefit package is rather limited in scope, and excludes, among others, dental care for adults and most rehabilitative and physiotherapy services. Furthermore, co-payments are required for a number of services. Out-of-pocket (OOP) spending amounted to 41.8% in 2017, one of the highest proportions in Europe.

Key reforms aim to improve healthy life expectancy as well as quality and efficiency of service delivery

Target actions continue to include the promotion of healthy and active lifestyles, enhancing the quality and efficiency of health care services, emphasizing a person-centred health care approach, and developing integrated health care, as well as improving accessibility and reducing health inequalities.

A key challenge is ensuring sustainability and stable financing of the health care sector

Since 2013 there has been a focus on the financial sustainability of the system. In 2017, parliament passed a law for the introduction of a Compulsory Health Insurance System, with the aim of increasing revenues for health. Under the new system, entitlement to the full benefit basket would be linked to the payment of social health insurance contributions. However, the reform has been postponed to 2021. Since 2018, the government has increased the compulsory state social insurance contribution from payroll by 1 percentage point, which is currently implemented and is used specifically to fund health care.