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The nation of Austria has a two-tier health care system in which virtually all individuals receive publicly funded care, but they also have the option to purchase supplementary private health insurance. Care involving private insurance plans (sometimes referred to as "comfort class" care) can include more flexible visiting hours and private rooms and doctors. Some individuals choose to completely pay for their care privately.



Healthcare in Austria is universal for residents of Austria as well as those from other EU countries. Students from an EU/EEA country or Switzerland with national health insurance in their home country can use the European Health Insurance Card. Self-insured students have to pay an insurance fee of EUR 52.68 per month.

Enrollment in the public health care system is generally automatic and is linked to employment, however insurance is also guaranteed to co-insured persons (i.e. spouses and dependents ), pensioners, students, the disabled, and those receiving unemployment benefits. Enrollment is compulsory, and it is not possible to cross-shop the various social security institutions. Employers register their employees with the correct institution and deduct the health insurance tax from employees' salaries. Some people, such as the self-employed, are not automatically enrolled but are eligible to enroll in the public health insurance scheme. The cost of public insurance is based on income and is not related to individual medical history or risk factors.

All insured persons are issued an e-Card, which must be presented when visiting a doctor (however some doctors only treat privately insured patients). The e-Card allows for the digitization of health claims and replaces the earlier health insurance voucher. Additionally the e-Card serves as a valid ID.

Hospitals and clinics can be either state-run or privately-run. Austria has a relatively high density of hospitals and physicians; In 2011 there were 4.7 Physicians per 1000 people, which is slightly greater than the average for Europe. In-patient care is emphasized within the Austrian healthcare system; Austria has the most acute care discharges per 100 inhabitants in Europe and the average hospital stay is 6.6 days compared with an EU average of 6.

By 2008 the economic crisis caused a deep recession, and out-of-pocket payments for healthcare increased to become 28% of health expenditures. By 2010, Austria's public spending has decreased overall, but it was 15.5%, compared to 13.9% fifteen years earlier.

In 2010 under the Chancellorship of Werner Faymann, the Social Democratic Health Minister Alois Stöger began the process of reform as a response to rising healthcare costs and difficulties with capacity. The system is financed in part with public debt which had become a significant challenge in the aftermath of the recession which hit Austria in 2009. The reforms for 2013 aimed to increase capacity, improve the quality of care, and address fiscal concerns in concert with the Finance Ministry. A key outcome of the reform with the introduction of a budget cap on healthcare expenditure. The idea of structural reform was not entertained. Because of the federal structure of Austria the legal structure of the social security programme is unusually complex with multiple entities at the state level under the umbrella of the national institution: making adjustments to the federal framework would present a constitutional issue.

Structure
Austria's health programs are funded by the sickness insurance fund known as the Krankenkasse, which in 2013 took 11.0% of the GDP, which was above the average of the E.U average of 7.8% of GDP. Austria's healthcare system is decentralized, and operates with a system similar to United States federalism. Each of the nine states and the federal government of Austria have legal limitation and roles in their healthcare system. Federal Ministry of Labor and Social Affairs is the federal aspect, its role is to develop the framework for the services that are offered, and handle the sickness insurance fund known as the Krankenkasse, which funds Austria's healthcare system. The role of the Provinces is to manage and provide the care as needed. The provision of healthcare is ultimately carried out jointly by federal, provincial, and local actors. Since Austria's health program covers a vast array of social insurance including but not limited to unemployment insurance, family benefits, accident insurance, the overall bureaucracy is vast. While the Krankenkasse is the primary fund, Austria social protection network actually implemented by 22 smaller funds, 19 of which are purely for sickness and all of which by public law are self-governed in order to insure decentralization. The funds are also differentiated to allow for effective risk pooling, which is why membership is compulsory and citizens are generally unable to select which fund they will belong to.