Latvia

Abstract

Abstract This chapter offers an in-depth look at health politics and the tax-financed health system in Latvia. It traces the development of the Latvian healthcare system, characterized by tension between central and local government, increasing commercialization, and chronic public underfinancing. Since independence in 1991, Latvia first decentralized then recentralized health financing. The state has taken the back seat in provision of health services and allotted larger roles to private providers and to solutions such as out-of-pocket payments that emphasize individual responsibility. In Latvia, life expectancy is among the lowest, and unmet needs are high. As the chapter argues, because of the country’s cultural politics, healthcare rarely tops the political agenda.