Denmark is one of the world leading modern societies and its concerns on health care and social system might be represented through a high level of public expenditure in Health Care in an attempt to elevate lifestyle standards and increase life expectancy of the population.
Denmark has a highly protective social and health system (in average superior to other countries and quite above OECD average). Its Government tries to deliver equitable distribution of wealth and equal accessibility to all citizens and around 85% of health care expenses are financed by public funds.
Danish central State is in charge of legislation and provides national guidelines for supervision, monitoring and general planning of the overall framework of the health economy. The responsibility for running the public health service is decentralized from the Central State until municipalities and the ability of reallocation is delivered at the municipality level.
As stated in the OECD table below Denmark has the highest contribution in public expenditure: private has near 1 % of influence (small procedures of primary care, dental care, and prescription medication and dermocosmetical products). There are no medical insurance companies which implicate neither bureaucracies nor time lost for patients needing medical care. Denmark has a higher overall health bill in average as healthy people are directly paying treatment of sick people through the universal taxes.
Denmark has a public spending on health over 2% of GDP, with the average on other countries close to 1% of GDP across OECD countries.
The majority of funding arrives from public taxes applied to everyone who creates a public private ratio much more state controlled than in Portugal whereas funding comes almost at the same proportion: private, public and other active agents like insurance companies or medical associations.
Although the funding of health services arises mainly from state contribution (after tax), Denmark enjoys one of the lowest per capita spending on health care (less than 300 USD per capita at parity prices because the system is simpler and less profit-oriented, it ends up being cheaper) which represents around 15% of the total spending (OTC products and self-medication).
While in Portugal we may find public hospitals; private or mixed administration, in Denmark the administration of hospitals and workforce is oriented by the Ministry of the Interior, while primary care facilities and community care are at charge of the Ministry of Social Affairs. Citizens can go to a physician for free and the public health system entitles each citizen to his own doctor.
The Government has the power to establish health policies, legislation and regulation on the health sector while at the same time holds responsibility to promote efficiency and quality service –forcing it to promote innovation through compensation on medical research developments.
Unlike happened in Portugal Denmark adopted measures to prevent excess of expenditure in the Health sector in order to be funded only by directed taxes or by privates rather than reimbursing or co-funding treatments decided by patients such as having one central organization responsible for management of personnel and costs of all country and so can reallocate easier and closer the right tools/human resources to match demand for health care while for example in Portugal each hospital has own administration and thus presents less flexibility.
The easy and free access for Danish citizens of primary medical care is different from the Portuguese reality where due to lack of coordination some processes may take longer (e.g.: queuing phenomenon) or have fee costs (e.g.: urgencies). A clear belief on anticipation is assumed while Danish authorities promote continuously national screenings among children. These measures release parents from extra costs and accommodate to daily life of their citizens.
In Portugal, for several years, occurred a lack of regulation on the health care industry and corruption aroused from various points and has been the escaping route of taxes paid by citizens in a loss fund investment; this situation is trying to be tackled but there is not still a white fire that would put an end on this issue. and that will impose a long-term recover of the health care market.
Comparing to Portugal, Denmark has understood earlier the importance of such investment in long-term planning of the economy and the inherent value of a healthy life of citizens (Danish health care system fully covers every citizen) and its further impact on the economy and so, developed a tax-funded state-run universal health care system (in tune with the Scandinavian economies) meaning that it is free for all and funded by direct taxes.
These measures could be reapplied in Portugal since they are already proven to bring efficacy to the health care of citizens at lower costs (per capita).
André Oliveira Martins