As a result, the contribution of out-of-pocket funding in Latvia is substantially higher than in most OECD health systems, at 38.5% of total national expenditure on health in 2013. The high co-payment for services is acknowledged by the Ministry of Health as stopping some 12-20% of Latvians from accessing health services. A recent survey found that 23.5% Latvians who forewent health care cited cost as the reason (Eurostat, 2015).