Budgeting and Spending in Palestine’s Health Care System: Addressing Gaps and Opportunities (2000-2024)

Abstract

Objectives: This study analyzes health financing patterns in Palestine from 2000 to 2023, with a focus on the 2023 expenditure indicators. It explores the growing burden of household out-of-pocket (OOP) payments, the allocation imbalance between curative and preventive care, and the need for increased government investment in health.

Methodology: A systematic literature review, secondary data analysis, and expert interviews were conducted using data from the Palestinian Ministry of Health (MoH), Ministry of Finance, and the Palestinian Central Bureau of Statistics (PCBS). The latest indicators from 2023 were integrated to update policy insights.

Results: In 2023, total current health expenditure (CHE) reached $1.87 billion, or 10.4% of GDP. Government contributions accounted for 46.4% of this spending, while households financed 42.1% through OOP payments, which accounts for more than double the WHO’s recommended ceiling. Per capita health expenditure stood at $363. Despite health expenditure reaching 10.4% of GDP in 2023, significant imbalances persist, with approximately 71–75% of spending directed toward curative care compared to only 1.5–4.8% allocated to preventive services. Combined with low government health expenditure (4.9% of GDP), this raises concerns about efficiency, equity, and long-term fiscal sustainability.

Originality: This policy brief provides a context-specific analysis using the latest national data. It highlights financial vulnerabilities in the Palestinian health system and offers evidence-based recommendations to improve equity and efficiency under conditions of political and economic constraints.