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Latvia is located in northern-eastern Europe, sharing its borders with Estonia, Russia and Lithuania, with a coastline along the Baltic Sea. Latvia has a population of 2.2 million people. It gained independence from Soviet Union in 1991 and subsequently joined the European Union in 2004.
The Latvian healthcare system has been continuously developing over the last two decades especially since gaining independence. However, the Latvian health sector lags behind its fellow European Union members and is still maturing, with the aim of matching healthcare standards in fellow EU member states.
Latvia has been severely affected by the 2007 financial crisis. Which has impacted the Latvian government’s capacity to adequately fund the health sector in the country. There is a shortage of medical supplies, lack of advanced medical equipment and some healthcare facilities are outdated, requiring reconstruction. There is also a shortage of trained medical professionals in the country. However, the more recently developed private healthcare facilities in the capital Riga are up to the standards normally found in other Western European countries.
In 2002, the Government of Latvia adopted the National Public Health Strategy of Latvia – Health for All by 2010. The fundamental aim of this strategy is to improve the health of the population; to reduce inequality in health, to promote a healthier lifestyle for citizens, to develop human resources for the Latvia public health sector and to improve the general quality of healthcare. Although financial hardships in recent years have burdened the Latvian economy and the government’s ability to implement changes to the Latvian healthcare system, the country is still working towards updating and improving the overall Latvian health sector.
The Latvian public health sector is funded through the State Compulsory Health Insurance Agency deriving its revenue from general taxes. Employees and employers must make mandatory contributions to the Latvian social security scheme, which entitles the employee and their dependents to public health services. Vulnerable groups are permitted to pay a small fee each year to have access to Latvian public health services. Publicly run Latvian healthcare services are available to all Latvian citizens and resident expatriates who contribute to the compulsory state funded healthcare system. Private healthcare facilities are also present in Latvia, providing health services to those who can afford them.
If you are an expatriate relocating to Latvia without an existing offer of employment, you will need to take out international private health insurance for Latvia in order to obtain a residence permit for the country. It is also strongly advised that all foreign nationals, visiting or working in Latvia, obtain Latvian international health insurance as the standard of state provided medical care in the country is not fully adequate to meet all healthcare requirements. Cover for repatriation is strongly recommend.
The Ministry of Health in Latvia is responsible for developing healthcare policies and regulating the Latvian healthcare system, with local Latvian authorities entrusted with autonomy to manage district health sectors. The Public Health Agency, which is a government agency, working under the supervision of the Ministry of Health in Latvia has the responsibility for managing health issues such as: infectious diseases, AIDS and STIs, environmental health, the coordination of emergency situations, addictions, mental health, health promotion and prevention and public health analysis.
As the Latvian healthcare system is largely decentralized, local government authorities have a great deal of autonomy to run regional health services. The Latvian local government authorities are allocated a budget and are set minimum amounts to spend on their district healthcare services. The local authorities are allowed to exceed their healthcare budgets – if they can make funds available from other sources – but they must not fall short of the budgeted target spend.
The Latvian publicly run healthcare system will provide citizens of Latvia, and permitted registered foreign nationals, with basic health services. The Latvian state will provide patients with health services which include: child and maternity care, post-surgical rehabilitation, preventative healthcare, treatment for serious diseases, immunization vaccinations and emergency treatments. It also provides selected groups with prescription medication.
There are certain fees patients must pay when seeking public health services in Latvia although people belonging to vulnerable groups – pregnant woman, diabetics and elderly persons – are exempt from any Latvian health charges. A patient does not need to pay for an appointment with a doctor or for referrals to a consultant. In recent years, the Latvian healthcare sector has increased patient’s fees for medical care and treatment – the higher co-payments for health services is partly due to increasing healthcare costs placed on the public health sector resulting from high inflation rates, which the Latvian economy has been experiencing. All medical costs which are not covered by the basic healthcare programme in Latvia need to be met by the patient.
Latvian citizens often take out local private health insurance to give themselves coverage to medical services which are not covered as part of the public Latvian healthcare system. However, some local health insurance policies have been criticized because of the lack of sufficient medical coverage for policy holders and duplication of services already included in the public healthcare system. This is counter-balanced by giving a patient access to privately run healthcare facilities, which generally offer better equipped healthcare services. The scope for wider use of private health services is limited by the cost of insurance cover which is beyond the reach of many of the Latvian population.
Primary care is delivered by doctors located in healthcare centres in the cities and larger towns. Patients can select the doctor of their choice, but a patient must confirm the doctor is registered to work in the public healthcare system for the patient to have access to free services. In rural areas of Latvia, the access to doctors is more limited. The main role undertaken by doctors in Latvia is to prescribe medications, treat illness, and basic health education and provide preventative healthcare services. Doctors will also refer patients to a consultant and a public hospital if more extensive medical treatment is required. In the rural areas of Latvia, clinics will normally have a doctor, as well as paediatricians, midwives, nurses and dentist present to deliver health services.
The capital Riga has the most comprehensive health services available in Latvia. There is 24-hour emergency care, medical specialists and general healthcare services that are readily available. Consultants are located across the country, but Riga is home to some of the best trained medical consultants in the country. However, seeking health services from the Latvian state healthcare system normally means a patient will incur significant waiting times.
There are 10 hospital facilities in Riga. District hospitals in Latvia are equipped to offer medical treatment for in-patient and out-patient care, paediatric care and surgical procedures. In the case of medical emergency, all patients can receive initial treatment free of charge, but will be required to pay or prove insurance coverage for prolonged medical treatment.
Private healthcare services are present in Latvia, but are mostly confined to affluent regions of the country because they are relatively expensive for many Latvians. The majority of Latvian private healthcare facilities can provide out-patient care, and a small number can provide in-patient care. The overall cost of private healthcare services in Latvia is expensive, and it is recommended that a patient has Latvian private medical insurance coverage to meet these health services costs.
As Latvia is a member state of the European Union (EU), there is a reciprocal health agreement in place with other EU members. The holder of a European Health Insurance Card (EHIC) is entitled to public health services in emergency situations; however, it does not include extensive medical treatment or repatriation costs for a patient. All foreign nationals visiting Latvia are recommended to hold Latvian international health insurance to give them full medical coverage while in the country.
If you are traveling with a pre-existing medical condition, which requires medication, you should take ample supplies with you as Latvia has limited access to modern medical prescriptions. Prior to your visit to Latvia, you should be immunized against tick-borne encephalitis as it is common to Latvia; the vaccination can be given by a doctor in your home country.
If you are traveling in remote or rural areas of Latvia, emergency services are limited. In the case of a medical emergency, an air ambulance maybe required; however, the cost of such a service is very expensive and the ability to pay or a insurance document proving coverage may be required before a patient will be medically evacuated.
As a foreign national in Latvia, you will find Latvia public health services inadequate, but there are a number of privately run healthcare facilities which provide a higher standard of medical care for patients. Although it is expensive a patient can be assured that medical treatment from private healthcare providers – especially in Riga – meet the standards normally expected by western European nationals. The private health facilities are well equipped and provide health services to meet a vast range of medical needs. It is important to ensure you have adequate Latvian international health insurance to give you comprehensive medical coverage while you are in Latvia and to safeguard you from any extensive medical costs.
There are clearly flaws in the Latvian healthcare system. Several years of financial hardship has placed pressure on the Latvian National Public Health Strategy, but the government is slowly working to improve the health sector, with an overall aim of ensuring citizens of Latvia have the same standard of healthcare services as their fellow EU counterparts. Currently the Latvian healthcare system is burden by general economic factors affecting the country,but there is a strategic plan in place to implement change in the country's public health sector; medical professionals are receiving better training, but there is a general shortage of doctors and consultants in the country. There is also limited state-of-the-art medical equipment available, in out-dated healthcare facilities. The high unemployment rate (17% in 2009) means a large proportion of Latvians struggle to make the co-payments for health services. The Latvian healthcare system has been under-funded for an extensive period of time, which it is evident in the state of services today. Part of the Latvian healthcare sectors development is to improve funding in order to provide a stronger health sector.
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