what is more outofpocket payments represent of final household consumption compared to the eu average of the seventh highest among member states outofpocket payments include copayments for a wide range of nhs servicesincluding primary care visits in portugal of people from lowincome households reported going without a medical examination when needed for financial reasons in above the eu average of figure and significantly higher than the rate for the highest income group although who estimates show modest levels of catastrophic expenditures from private spending on health in portugal barros borges forthcoming