Overview

The centralized health system delivers universal access and free choice of providers

Luxembourg’s health system operates under a statutory health insurance (SHI) model, based on solidarity, mandatory coverage for economically active individuals, income-based contributions, and state financial support. The system ensures universal access and free choice of providers, with costs shared between employers, employees, and the state. The 2023 merger of the ministries of Health and Social Security into the Ministry of Health and Social Security (M3S) aims to streamline health care planning, legislation, and financing. The Ministry of Family Affairs continues to oversee long-term care (LTC) services, while the National Health Fund (CNS) manages SHI and LTC insurance.

Luxembourg has one of the highest shares of public financing for health care and relatively low household out-of-pocket payments

In 2022, Luxembourg’s total health expenditure per capita was EUR 4315 PPP. Public spending accounted for 86% of current health expenditure (CHE), placing Luxembourg among the top five in the WHO European Region. The benefits package is comprehensive and while user charges are required for most health services, household out-of-pocket spending on health represented less than one tenth of health expenditure at 8.7%, which is significantly lower than the EU average (14.5%).

Challenges in human resources are being met with new domestic training programmes and other initiatives to boost health workforce recruitment

According to the most recent available data, the density of practicing physicians in Luxembourg is below the European average and the lack of domestic medical training programmes means that the country relies heavily on foreign-trained doctors. In contrast, the number of nurses in the country is relatively high but this part of the health workforce is also characterized by a significant share of cross-border employees, attracted by favourable working conditions and competitive salaries. The dependence on foreign-trained health professionals, a progressively aging health workforce and shortages are being addressed through new domestic educational programmes, particularly for nurses, while the 2023 national health plan aims to recruit over 1200 additional doctors by 2030.

Health system sustainability and quality of care have been core policy concerns

The comprehensive 2010 Health Reform targeted cost containment and quality of care. It laid the foundation for future laws on eHealth infrastructure and established institutions like the Scientific Council for Health Care. The reform also introduced overall hospital budgets to control costs. The 2017 long-term care reform aimed to enhance care quality, restructure benefits, invest in prevention, and set clear standards. The 2018 Hospital Law further advanced hospital care, mandating transparency in hospital activities and aligning services with demographic trends, medical progress, and population health needs.

Upcoming policy efforts will focus on health care digitalization, the health care workforce, and pharmaceutical products regulation

A digital health care workforce register and a legal framework to foster multi-professional collaboration, autonomy, and task-shifting opportunities are in progress to address health care workforce shortages and enhance the retention of health professionals. New integrated care networks for specific diseases will further improve coordination and task-sharing. Additionally, a national digitalization strategy is being developed to streamline IT systems, enhance health information flows for primary users, facilitate secondary data use, and prepare for the European Health Data Space. To address the current lack of a national pharmaceutical regulation agency, a 2020 draft bill aims to establish the National Agency for Medicines and Health Products.