most of the unmet medical needs are attributable to care being too expensive with waiting lists and geographic barriers accounting for a relatively small share disparities in the use of specialist care diagnostic services and basic medical tests are largely connected to higher health literacy of the welloff affecting the utilisation rates of preventive services and screening flatrate copayments limiting access to mainly specialist outpatient care for lowincome people and lowquality seivices and long waiting lists particularly in the southern regions that lead citizens to turn to private health rare with ability to pay for those services positively associated with socioeconomic status the majority of regions have implemented or increased different levels of copayments on pharmaceuticals some regions have also implemented user fees for the inappropriate use of emergency services