INDICATORS

76. INSURANCE COVERAGE
Definition: The indicator is defined as the proportion of the population covered by
health insurance, taking into account both public and private insurance schemes. Public
(government/social) health insurance refers to tax-based public health insurance including
social security contribution schemes. Private health insurance refers to insurance schemes
financed through private health premiums, i.e., payments that a policyholder agrees to make
for coverage under a given insurance policy, where an insurance policy generally consists of a
contract that is issued by an insurer to a covered person.
Calculation:
1) OECD: proportion (%) of the population covered by a) public and b) private health
insurance.
1a) Public, i.e. government/social health insurance: Share of population (%) eligible for
a defined set of health care goods and services that are included in total public health
expenditure: total health care, in-patient and acute care, out-patient medical care and
pharmaceutical goods. Coverage in this sense is independent of the scope of cost-sharing.
1b) Private health insurance (PrHI): Total PrHI coverage (%) is a head count of all
individuals covered by at least one PrHI policy (including both individuals covered in their
own name and dependents). To avoid duplications, it should not refer to the number of
PrHI policies sold in the country, as individuals may be covered by more than one PrHI
product. Similarly, total population coverage is not necessarily the sum of PrHI coverage by
different types, as an individual may hold more than one PrHI policy.
2) The EU Social Protection Committee Indicator HC-P3 (2008): “The proportion of
the population covered by health insurance”, defined as the percentage of the population
covered by public health insurance (which is defined as tax-based public health insurance and
income-related payroll taxes including social security contribution schemes) + the percentage
of the population covered by private health insurance including: Private mandatory health
insurance, Private employment group health insurance, Private community-rated health
insurance, and Private risk-rated health insurance. Recommended data source is OECD and
national data sources.
Notes:. Preferred data source is OECD (based on national data). It also the recommended
source for the EU Social Protection Committee indicator. For OECD definitions and
explanations concerning public and private health insurance, please see the OECD Health
Data, section “Definitions, Sources and Methods”.
77. EXPENDITURES ON HEALTH
Definition: Total total national health expenditure as percentage of gross domestic product.
Divided into total, public and private sectors. Total national expenditure on health is the
sum of general government health expenditure and private health expenditure in a given year,
calculated in national currency units in current prices. Gross domestic product (GDP) is the
total market value of all final goods and services produced within a country in a given period
of time. This corresponds to the total sum of expenditure (consumption and investment) of
the private and government agents.
Public expenditure on health care: Public funds include state, regional and local Government
bodies and social security schemes. Public capital formation on health includes publicly
financed investment in health facilities plus capital transfers to the private sector for hospital
construction and equipment.
Private expenditure on health care: Private sources of funds include out-of-pocket payments
(both over-the-counter and cost-sharing), private insurance programmes, charities and
occupational health care.
129