Overview

Luxembourg has a mandatory statutory health insurance (SHI) system for economically active individuals, which also covers their non-earning spouse and children (co-insured). In 2021, SHI covered 92% of the resident population, and the gap in universal coverage can be partly explained by existing exemptions for the people working in international organizations located in the country. As Luxembourg is one of the smallest countries in the world, the health system is highly centralized.

Health expenditure per capita in Luxembourg is among the highest in Europe, reaching US$ 7540 (adjusted for differences in purchasing power) in 2022. The share of public funding for health care is also high (86%). Over the past decade, household out-of-pocket (OOP) payments have been low and stable, remaining at approximately 9% of health spending in 2022. OOP spending is related mainly to direct spending on pharmaceuticals, outpatient care, long-term care and dental care.

Key reforms in the past 15 years have focused on the health system’s sustainability and quality of care. The 2010 Health Reform targeted cost-containment and quality improvement while laying the groundwork for multiple laws to come, such as establishing the eHealth infrastructure. Long-term care was extensively reformed in 2017 to enhance quality, restructure benefits and invest in preventive services while the 2018 Hospital Law marked a pivotal milestone for hospital care. The recent merger of the ministries of Health and Social Security aims to improve policy alignment and coordination. Upcoming policy efforts focus on the development of a comprehensive digitalization strategy, the establishment of a new regulatory authority for pharmaceuticals and strengthening of the health workforce with the creation of additional education programmes, a digital health workforce register and enhanced task sharing.