Have bailouts shifted the burden of paying for healthcare from the state onto individuals?

  • Conor Loughnane
  • Aileen Murphy
  • Mark Mulcahy
  • Celine McInerney
  • Valerie Walshe
Original Article



The financial crisis that enveloped Europe in 2009 created financial pressure for governments and required a number of countries to obtain a financial bailout from the IMF. The purpose of this paper is to examine the effect of the financial crisis on public health expenditure in bailout countries and if bailouts shift the burden of paying for healthcare from the state onto individuals.


Quantitative health expenditure data were collected from the WHO and OECD for the period 2004–2015 and evaluated using a comparison of means Welch’s t test.


The majority of bailout countries recorded a decrease in public health expenditure as a percentage of total government expenditure, with Ireland recording the largest decrease with government health expenditure as a percentage of total government expenditure, falling by 22% (P < .01). In addition, the results also suggest that the burden of paying for healthcare shifted from the state onto individuals in three countries, namely Hungary, Ireland and Portugal, where public health expenditure declined and private expenditure increased significantly.


The ramifications of shifting the burden of paying for healthcare from the state onto individuals at this point remain unclear with further research required to identify the long-term consequences for healthcare.


Bailouts Europe Financial crisis Healthcare expenditure 


Funding information

Conor Loughnane received financial support from the Health Service Executive for conducting this analysis.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical consideration

This article does not contain any studies with human participants or animals performed by any of the authors.


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Copyright information

© Royal Academy of Medicine in Ireland 2018

Authors and Affiliations

  1. 1.Cork University Business SchoolUniversity College CorkCorkIreland
  2. 2.Health Service ExecutiveModel Business ParkCorkIreland

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