Public spending on health accounted for 79% of Slovakia's total health expenditure, according to the World Health Organisation (WHO). Most of this came from social security contributions. The remaining 21% was accounted for by voluntary, mostly out-of-pocket (OOP) payments.
Companies pay 10% of wages in healthcare contributions, with employees paying another 4%. In 2017 the government reduced the total state insurance contribution for non-workers to €1.28bn, from €1.36bn, and raised total workers' contributions by €250m, to €3.1bn. Pressure has persisted for wage increases in the healthcare sector, with several strikes, despite pay rises in recent years. The country faces a shortage of doctors and nurses. The Slovak Society of General Practice reported in 2019 that on average there are 2,200 patients per GP and that 30% of the country's GPs are aged over 65. Slovakia was ranked 19th among OECD countries for pharmaceutical spending per head in 2019 (in US dollar terms), but, at 24.4%, the share of total healthcare spending on pharmaceuticals was the fifth highest in the OECD. The volume of drug consumption is high by OECD standards.