Most EU countries have achieved universal coverage for a core set of health services, although the range of services covered and the degree of cost-sharing vary. Effective access to care can be restricted for financial reasons, but also because of health workforce shortages, long waiting times or long distance to travel to the closest health care facility. In most EU countries, only a small share of the population reported unmet needs for health care in 2018, but this proportion was higher among low-income households, mainly for financial reasons. On average across EU countries, around a fifth of all health spending is paid out-of-pocket by households, but with wide variations across countries. In general, countries that have a higher share of out-of-pocket spending also have a higher proportion of the population facing catastrophic out-of-pocket payments for health services, particularly among low-income groups. Although the number of doctors and nurses per population has increased over the past decade in nearly all EU countries, shortages persist in many countries and were brought to light during the COVID‑19 pandemic. Long waiting time for some health services such as elective surgery is an important policy issue in many EU countries, as it restricts timely access to care and generates patient dissatisfaction. Even before the COVID‑19 pandemic, waiting times for elective surgery were on the rise in many countries as the demand for surgery was increasing more rapidly than the supply.