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EU Households Shoulder 15% of Health Costs, But Burden Varies Sharply Across Europe

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A new analysis by Euronews Health, using Eurostat data, reveals that European households are directly paying for a significant share of their medical costs — but the financial burden varies dramatically from country to country.

Across the European Union, household out-of-pocket payments account for about 15 per cent of total health care spending. That means families, on average, pay €15 out of every €100 in medical expenses directly from their own pockets. While mandatory health insurance covers just over half (51 per cent) of total costs and governments contribute about 30 per cent, households still fill the gap — with sharp regional disparities.

At one end of the scale, Luxembourg has the lowest share of household out-of-pocket payments, at just 8.5 per cent, followed closely by France (8.9 per cent) and Croatia (9.4 per cent). At the other, Bulgaria tops the list with 35.5 per cent, while Latvia (35.1 per cent), Greece (34.3 per cent), and Serbia (32.1 per cent) also record high levels.

Dr. Joseph Piscopo, a health economist with Malta’s health ministry, said economic strength plays a key role. “Stronger economies can allocate more financial resources to their health systems and, consequently, achieve lower levels of out-of-pocket health expenditure,” he explained.

Among the EU’s largest economies, Italy shows the highest household contribution at 22.3 per cent, followed by Spain at 20.9 per cent. France and Germany rank among the lowest, while the United Kingdom — with data from 2019 — sits near the EU average at 15.9 per cent. In the Nordic region, out-of-pocket shares are below average in Sweden (13.4 per cent), Denmark (13.9 per cent), and Norway (14.1 per cent).

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Experts say national health coverage policies are the main factor behind the differences. Jonathan Cylus of the London School of Economics noted that “who is covered, what services are covered, and how much of the cost is covered” are crucial determinants. He added that in countries such as Bulgaria, people who fail to pay their social insurance contributions are excluded from public coverage, forcing them to pay entirely out of pocket.

Pascal Garel, head of the European Hospital and Healthcare Federation (HOPE), said countries with extensive public or social health insurance schemes — such as France, Germany, and Sweden — tend to offer comprehensive benefits and strong protection for vulnerable groups. In contrast, countries like Bulgaria and Greece have limited benefit packages and weaker safeguards against catastrophic expenses.

Eurostat data also highlight how much people spend each year. On average, EU residents paid €542 out of pocket for healthcare in 2023. The figure ranged from just €136 in Croatia to €1,176 in Belgium, and a staggering €2,396 in Switzerland.

France recorded the lowest amount among Europe’s five biggest economies, at €410 per person annually, while Italy topped the group at €718. Garel noted that wealthier and older populations — particularly in Italy and Germany — drive higher spending due to greater demand for long-term and chronic care.

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Genetic Differences May Shape Effectiveness of Popular Weight-Loss Drugs, Study Finds

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Genetic variations may help explain why some patients respond better than others to widely used weight-loss medications, according to new research that points to the potential for more personalised treatment approaches.

Drugs such as Ozempic, Mounjaro and Zepbound have transformed the treatment of obesity in recent years. These medications belong to a class known as GLP-1 receptor agonists, which mimic a natural hormone that regulates appetite and blood sugar, helping people feel full for longer. Despite their growing use, patient outcomes vary widely, with some individuals losing less than 5 percent of their body weight while others achieve reductions exceeding 20 percent.

The study, conducted by researchers at the 23andMe Research Institute and published in Nature, examined genetic data alongside patient-reported experiences to better understand these differences.

Researchers analysed information from nearly 28,000 participants who had taken GLP-1 medications for a median period of just over eight months. Their findings identified specific genetic variants that appear to influence how individuals respond to these treatments.

One such variation in the GLP1R gene was linked to improved effectiveness. Individuals carrying a particular version of this gene lost an average of 0.76 kilograms more than those without it during the study period. Another variant in the GIPR gene was associated with an increased likelihood of side effects such as nausea and vomiting among patients taking tirzepatide-based drugs, though it did not affect weight loss outcomes.

Noura Abul-Husn, chief medical officer at the research institute, said current approaches to weight management often rely on trial and error. She noted that patients frequently begin treatment without clear expectations about how effective a drug will be or what side effects they might experience.

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Experts not involved in the study said the findings offer useful insight but should be interpreted with caution. Marie Spreckley of the University of Cambridge said the genetic effects identified are relatively small in clinical terms, especially compared with the typical weight loss of 10 to 15 percent seen in trials of these medications. She added that factors such as dosage, treatment duration, sex and drug type likely play a larger role in determining outcomes.

Still, researchers believe the results could mark a step toward more tailored therapies. Cristóbal Morales, a specialist in metabolic health in Spain, said the ability to predict how patients will respond to treatment through pharmacogenomics could improve both drug selection and safety.

The findings highlight the growing interest in personalised medicine, where treatments are adapted to an individual’s genetic profile, though further studies are needed to confirm how these insights can be applied in clinical practice.

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Seven-Day Meditation Retreat Linked to Measurable Changes in Brain and Body, Study Finds

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A new study by researchers at the University of California San Diego suggests that a week of intensive meditation and mind-body practices may lead to measurable changes in both brain activity and physical health, highlighting a deeper connection between mental experience and biological function.

The findings, published in Communications Biology, indicate that consistent mental practices can activate biological pathways linked to brain flexibility, immune response, metabolism and natural pain relief. Researchers said the results point to a growing understanding that conscious experience and physical health are closely intertwined and may be used to improve overall well-being.

The study followed 20 healthy adults who participated in a seven-day residential retreat led by neuroscience educator Joe Dispenza. Participants completed about 33 hours of guided meditation along with lectures and group-based activities. Some elements were presented using an “open-label placebo” approach, meaning participants were aware that certain practices were described as placebos, yet previous research suggests such methods can still produce real effects through expectation and group dynamics.

To measure the impact of the retreat, researchers used functional MRI scans and blood tests before and after the programme. The results showed reduced activity in brain regions associated with constant internal thoughts, often described as mental “background noise,” suggesting more efficient brain function.

Blood samples also revealed changes linked to neuroplasticity, with lab-grown neurons exposed to post-retreat plasma showing increased growth and connectivity. Additional findings pointed to improved metabolic flexibility, as well as higher levels of endogenous opioids, the body’s natural painkillers.

Researchers also observed shifts in immune signalling, with both inflammatory and anti-inflammatory responses increasing in what they described as a more balanced and adaptive pattern. Participants reported stronger feelings of unity and altered awareness after the retreat, based on scores from a standard questionnaire used to assess such experiences.

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Hemal H. Patel, who was involved in the research, said the results go beyond simple stress reduction. He noted that combining multiple mind-body techniques appeared to influence several biological systems at once, with measurable effects in both brain scans and blood chemistry.

The study also found that patterns of brain connectivity observed after the retreat resembled those previously associated with psychedelic substances, suggesting that similar states may be achieved through meditation alone.

Despite the findings, researchers cautioned that the study was limited by its small sample size and lack of a control group. They said further research is needed to determine whether the same effects would be seen in larger and more diverse populations.

Alex Jinich-Diamant said the results provide rare biological evidence linking mental states to physical changes in the body. He added that the research offers new insight into how attention, belief and structured practices may leave measurable effects on human biology, opening potential pathways for improving health through non-pharmacological methods.

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Uzbekistan to Launch Nationwide State Medical Insurance System in 2026

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Uzbekistan will begin introducing a nationwide state medical insurance system from 2026, part of a broader overhaul of the country’s healthcare financing and service delivery. The reform will introduce digital referrals, a national health insurance fund, and a guaranteed package of essential medical services funded through the state budget. Officials say the changes aim to improve efficiency, expand access, and reduce informal payments.

“State health insurance is a social protection system designed to guarantee access to quality healthcare services,” said Zokhid Ermatov, executive director of the State Health Insurance Fund.

Discussions about state medical insurance in Uzbekistan began in 2017, but implementing such a system required years of preparation. The State Health Insurance Fund was formally established in December 2020, and pilot programmes launched in the Syrdarya region in 2021 tested new financing mechanisms, regulatory frameworks, and digital health systems. In November 2025, the Cabinet of Ministers approved regulations governing how medical care funded through the state budget will be provided in public and private medical institutions, with the rules set to come into force on January 1, 2026.

At the centre of the new model is stronger primary healthcare. Patients will first visit their assigned family clinic, where doctors provide consultations, prescribe tests, and determine whether specialist care is needed. If necessary, patients will receive an electronic referral to hospitals or specialists. Emergency and urgent care will remain available without referrals.

The reform introduces a patient-centred financing model, where healthcare providers are paid by the State Health Insurance Fund based on services delivered. Primary healthcare will be funded through capitation payments, while hospital treatment will follow case-based payments, a structure designed to improve efficiency and treatment outcomes.

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A fully digital referral system will allow patients to choose hospitals from a list of institutions contracted with the State Health Insurance Fund using a government portal or mobile app. Referrals will remain valid for 60 days, and waiting lists and hospitalisations will be managed through a unified electronic health information system.

The insurance system guarantees essential healthcare services, including family doctor consultations, diagnostic tests, outpatient treatment, preventive screening, some medicines, hospital care, and certain rehabilitation services. Patients will not be charged additional fees for services included in the approved package.

Funding for the program will come primarily from the state budget, ensuring citizens do not pay direct insurance contributions. Priority access will be given to socially vulnerable groups, including children with disabilities, orphans, pensioners, pregnant women, unemployed citizens, and low-income families. The State Health Insurance Fund will allocate resources across regions to strengthen medical services and reduce inequalities.

International organisations have praised Uzbekistan’s approach, noting that general tax financing and universal coverage can improve financial protection and ensure predictable healthcare funding. Jessika Yin, Health Policy Adviser at the World Health Organization in Uzbekistan, said the reforms align with global trends toward universal health coverage.

If implemented successfully, Uzbekistan’s state medical insurance system could represent a major step toward universal healthcare, ensuring that people receive care without facing financial hardship.

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