Luxembourg

5.8%CHE/GDP

8.7%OOP/CHE

10.5%GGHE-D/GGE

86BGDP (USD)

660.8KPopulation

1%Unmet Needs - Total

1%Unmet Needs - Female

1%Unmet Needs - Male

Luxembourg is one of the smallest countries in the European Union (EU), with a population of 645,000 people. The life expectancy at birth was 83 years in 2022, which is 2.3 years higher than the EU average. The leading causes of death in Luxembourg in 2020 were circulatory diseases, such as stroke and ischaemic heart disease, cancer, and COVID-19.

Luxembourg’s health system is based on statutory health insurance (SHI), with mandatory participation for economically active individuals and income-based contributions. The Ministry of Health and Social Security of Luxembourg oversees planning and financing, while the National Health Fund (CNS) manages SHI and long-term care. Coverage is compulsory for most residents, including pensioners and minors, with family members coinsured. Universal access and free provider choice are central features, though voluntary affiliation requires an official address, which can be a barrier for some individuals.

Public funding of health care is among highest in EU

In 2022, current health expenditure (CHE) per capita in Luxembourg was US$ 6,956, representing 5.4% of gross domestic product (GDP). While for that year the per capita CHE for Luxembourg shows as almost double the average per capita CHE of EU countries (US$ 3,399), CHE as a share of GDP for Luxembourg is less than the average for EU countries (8.7%). Health expenditure from public sources in 2022 accounted for 86.9% of health spending, out-of-pocket (OOP) spending accounted for 9.0%, and voluntary health insurance accounted for 3.9% of the CHE.^[1] Public health spending in Luxembourg is among the highest in the EU and comes through a combination of state contributions (40%) and social security payments shared by employers and employees. Because the compulsory health insurance scheme offers extensive benefits, households in Luxembourg have the lowest out-of-pocket health spending in the EU (EU average is 19%). Roughly two-thirds of the population opt for voluntary health insurance to cover copayments and extra services.^[2]

Ambulatory healthcare professionals are paid fee-for-service, and hospitals negotiate budgets with the CNS. There is no gatekeeping, so patients can consult any provider directly, resulting in a hospital-centric system. While accessibility is high and the benefits package is broad, financial barriers persist, especially for low-income groups. Patients often pay upfront and are reimbursed later, which can cause temporary financial strain. Efforts to expand third-party payment systems are underway to reduce these burdens and improve access.^[2]

Reforms and future directions

Reforms have focused on sustainability and quality, with exemption mechanisms to protect vulnerable groups from cost sharing. However, information about these exemptions is not always easily accessible, limiting their effectiveness. Future policies aim to address digitalization, pharmaceutical regulation, and workforce development.

References

[1] World Health Organization, Global Health Expenditure Database, Indicators and Data (choose country)

[2] Luxembourg: Country Health Profile 2023, European Observatory on Health Systems and Policies