Act II · The stateStory 14 of 31
What GESY costs, and who pays
Households pay less than a third of GESY's contributions, and what employees have deducted from their payslips is only about a fifth of the total. The largest contributor is the state, which puts in 46% from the general budget.
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GESY, the general healthcare system, opened in June 2019 and has covered hospital care since June 2020. At the start of 2025 it had 992,000 people registered, slightly more than the resident population in Eurostat's count, since a register is not a census. It is paid for by a contribution that appears on every payslip, and by a larger one that does not.
Contributions to GESY in 2024, €1,674 m in all, by who paid them.
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Health Insurance Organisation, budget law for 2026 (actual figures for 2024) and audited accounts for 2024. For 2024 exact amounts exist for these three groups only. The state also pays the employer's rate for its own staff, which is counted under employers.
What the numbers say
An employee pays 2.65% of gross pay. The employer adds 2.9%. Then the state adds 4.7% of the same pay, and of every pension, out of the general budget. Pensioners pay 2.65% of their pension and the self-employed 4% of their income.
In 2024 that came to €1,674 million. The state paid €769 million of it, households €526 million and employers €379 million. The state is also an employer, and the 2.9% it pays for its own staff is counted under employers, so its full share is above 46%. With patients' co-payments, rebates from medicine suppliers and other income, the system's income was €1,832 million.
Where does it go?
What GESY paid for care in 2024, €1,699 m in all, by type of service.
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Health Insurance Organisation, audited financial statements for 2024, note on the cost of services. Medicines include pharmacists' fees and medicines used in hospital; supplies used in hospital are under medical supplies, not under hospital stays. Other is dentists, rehabilitation, palliative care, treatment abroad, payments to the public hospitals for services of general interest, medicines bought through the Ministry of Health, refunds of contributions and provisions.
GESY paid €1,699 million for care in 2024. Hospital stays took €623 million, more than a third. Medicines, with pharmacists' fees, took €356 million, outpatient visits to specialists €235 million and personal doctors €104 million. Spread over everyone registered, that is about €1,700 a person a year.
Running the organisation itself cost a further €26 million.
What it means for you
On a gross salary of €2,000 a month you pay €53. Your employer pays €58 and the state €94. So about €205 a month goes to GESY in your name, and a quarter of that is the deduction you see. Across all of GESY's contributions, employees' deductions come to about a fifth.
The other side is what you no longer pay at the door.
Share of all current health spending in Cyprus that households pay directly, not through tax, contributions or insurance.
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Eurostat, health care expenditure by financing scheme (hlth_sha11_hf), household out-of-pocket payment as a share of current health expenditure.
Before GESY, households paid 44% of all health spending in Cyprus directly, nearly three times the EU average of 16%. By 2024 it was 17%. When you use the system in 2026, a prescription item costs €1, a visit to a specialist with a referral €6, and a visit to an emergency department €10. Co-payments stop at €150 a year, or €75 for children and people on low incomes.
What people argue
Is it running out of money? The audited accounts show a surplus in every year but one: a deficit of €36 million in 2021, and surpluses of €66 million, €158 million and €114 million in the three years after. The accumulated surplus stood at €708 million at the end of 2024, of which €610 million was cash. The latest published actuarial study, the third by the International Labour Office, projects small deficits in 2025 and 2026 and a growing reserve after that, at today's contribution rates. The results for 2023 and 2024 were better than all three studies projected: 2024 ended €114 million ahead, against €56 million in the latest. Costs rose by 26% between 2021 and 2024, and income by 38%. No audited results for 2025 had been published by early October 2026; the budget for that year planned to draw €69 million from the reserve.
Why does the state pay so much? The law sets it that way. Without the state's share, the rates on pay would have to be nearly twice as high to raise the same money, by our arithmetic. The effect is that GESY gets almost as much from the general budget as from households and employers together. One view is that this spreads the cost of health care over all taxes and keeps the deduction on wages low. The other is that it hides what the system costs, because most people see only the 2.65%.
What about the public hospitals? The state hospitals were given five years to live on what GESY pays them, as private ones do. According to press reports, Parliament has extended that deadline twice, now to the end of 2026, and the state still covers their deficit: €127 million in 2023 and €92 million in 2024. The budgets set far less than that, €12 million for 2025 and €45 million for 2026; the budget for 2024 was also far below what was finally paid. The hospitals also received €143 million in 2024 for what the law calls services of general economic interest, part of it from GESY. The rating agency Moody's was quoted by the Financial Mirror in May 2026 as listing "persistent deficits" at the organisation that runs the state hospitals among the pressures on public spending. That is a different body from the GESY fund, whose accounts are in surplus.
How we know
Contributions by payer are from the Health Insurance Organisation's budget law for 2026, which prints the actual figures for 2024; they add up exactly to the contributions in its audited accounts. For 2024 exact amounts exist for three groups only. The law's label for the household group names employees, pensioners and people with other income; we take it to include the self-employed, which fits the organisation's own percentages. That employees alone pay about a fifth is from a chart in its Annual Report, which gives whole percentages.
Spending by type, the yearly results and the reserve are from the organisation's audited financial statements and its Annual Report for 2024. The figure for 2019, the first year, is an operating result. The projection is the third actuarial report of the International Labour Office, completed in February 2025, as summarised in that Annual Report. The per-person figure is our division by the number registered on 1 January 2025.
These are the organisation's own accounts. They differ from the European statistics used in other stories, which put GESY and the Social Insurance Fund together.
The share paid out of pocket is from Eurostat's health accounts. The subsidy to the public hospitals is from their organisation's budget laws; the five-year deadline and its extensions are as reported by the Cyprus Mail. The Moody's statement is as quoted by the Financial Mirror and was not checked against the agency's own text. The example on a €2,000 salary is our arithmetic on the rates the organisation publishes.