Despite the recent discussion about the abusive use of the SNS by international criminal networks, the guardianship does not have a general estimate of costs and debts.
The use of the National Health Service (SNS) by foreigners not resident in Portugal and the accumulated debts have been much debated in recent weeks, but concrete data on the phenomenon is scarce.
According to , the Central Administration of the Health System (ACSS) does not have precise estimates of the total amount owed, although some health units report high costs for caring for foreigners.
Between 2021 and 2023, the SNS charged around 73.3 million euros from countries in the European Economic Area and Switzerland and 14.6 million euros from Portuguese-speaking African Countries (PALOP), but there is a significant part of the costs that remains to be collected.
Local units reported that, in a single year, care for non-covered foreigners generated costs of at least R$1.2 million, while estimates indicate that the debt could exceed 15.8 million euros in three years.
Despite these numbers, Xavier Barreto, president of the Portuguese Association of Hospital Administrators (APAH), minimizes the financial impact, considering the debt a “drop of water” in the SNS budget, which is around 15 billion euros annually.
The debate gained momentum with reports of organized networks who bring foreigners to obtain care in the NHS, including pregnant women. However, Barreto believes that these cases represent a small portion of the problem.
“There will be everything, but the perception I have is that the organized networks that have been talked about will be a small part of the problem and what will weigh least on the SNS’s accounts”, he tells Público.
According to Alexandre Lourenço, president of the Local Health Unit (ULS) of Coimbra, the real challenge lies in access to expensive medicines and treatmentswhere the Portuguese system is more generous than many other countries.
“This is where the discussion should focus and where forms of regulation should be found”, says Alexandre Lourenço, who gives the example of Spain, which defined grace periods and payment of contributions to prevent misuse of your healthcare system.
Experts agree that any decision must be based on concrete data, avoiding hasty changes that harm the universal and inclusive spirit of the SNS.
