Who is Buying Voluntary Private Health Insurance in Portugal: A Comparative Analysis for 2014 and 2019

Abstract

The Portuguese health system is defined as a National Health Service with universal health coverage of the population and almost free access to health care at any point of delivery. Despite this, the percentage of people who report having voluntary private health insurance has increased from 16% to 20.5% between 2014 and 2019. This paper aims to estimate the main determinants for having voluntary private health insurance in 2014 and 2019. We use data collected by the National Health Survey of 2014 and 2019 to compare results. A logistic model is estimated to explain the decision to hold an insurance policy. The results show that despite the increase in the number of people with private health insurance, the determinants are similar. Except for the role of being male, having had flu vaccination and being unemployed, which became significant in 2019. The most relevant results are (i) people who benefit from health subsystems, (ii) people who report long waiting times for medical care, (iii) people who have been vaccinated against the flu, and (iv) people who report unmet health needs are less likely to have private health insurance. The results of this paper indicate some potential inequalities in access to health care.