The Short Notes series intends to provide analyses on key topics related with the health sector. This Short Note assesses whether the use of family doctors in the private sector in Portugal is solely due to a lack of access to family doctors in the National Health Service (NHS), or whether it stems from people's preferences, either because they value their freedom to choose their doctor or because they expect to have faster access, or for some other reason.
The most important factor in the use of a family doctor in the private sector is private health insurance and, more generally, the existence of dual coverage, in addition to the NHS, provided by public or private health subsystems. Unsurprisingly, the education and financial situation of the household strongly influence the purchase of private health insurance and, indirectly, access to family doctors in the private sector, pointing to a socially stratified pattern of use of primary care available in the private sector.
The growth of private health insurance, in terms of people covered, is promoting the development of a habit of using family doctors in the private sector, which is not solely, or even predominantly, the result of a lack of comprehensive coverage by family doctors in the SNS.
Since the lack of coverage by family doctors in the NHS is not the main determinant of use to family doctors in the private sector, it is not to be expected that greater coverage by family doctors in the NHS will significantly reduce the work of family doctors in the private sector. Consequently, there will tend to be structural competition, rather than merely short-term cyclical competition, to hire health professionals to provide care.
🌐 See report in Portuguese.
This report is part of the Social Equity Initiative , a partnership between Fundación ”la Caixa”, Banco BPI and Nova SBE.
Author of the study: Pedro Pita Barros and Carolina Borges da Cunha Santos.