• Spending overview
• Policy overview
• Diseases overview

Spending overview

Total spending on healthcare has grown steadily since the 1990s, when Belgium's spending was well below the OECD average. This prompted the government to increase public spending by 4.5% per year in real terms between 2003 and 2007. As of 2007 estimates, 75% of healthcare spending in the country was funded by the public sector. Belgium spent an estimated 11% of GDP on public and private healthcare in 2009. The Belgian health system is financed via compulsory social insurance, taxation and out-of-pocket payments.

Total spending on healthcare is expected to continue to rise as Belgium, like its European neighbours, increasingly grapples with the issue of population ageing. According to the High Council of Finance, the government will have to earmark more than €3.5bn between 2009 and 2011 to cover current expenses related to the country's ageing population and to fund future cost increases. However, with a forecasted sharp rise in the budget deficit in the near term, and plans to balance the budget by 2015, the government is implementing numerous austerity measures, including deep cuts to health spending.

Policy overview

The country’s fiscal deficit is expected to rise sharply over the next 5 years. One of the main measures to reduce the deficit includes deep cuts to health spending, which may result in healthcare becoming underfunded over this period. Health education and preventive medicine, are already under regional remit, with more aspects expected to be devolved to the regions, in order to reduce federal financial burden. The market for private insurance is small, but has been growing in response to cuts in public coverage.

Belgians currently make more frequent visits to the doctor than most other EU nationals, according to OECD figures, in part because of the lack of financial incentives to curb consultations. Although most of the provision is private, the responsibility for funding and oversight of most of the health system rests with the public sector. Government policy is likely to continue to try to maintain a substantial contribution to treatment from private pockets, as a disincentive to increasing demand.

Belgium currently levies a tax on pharmaceutical companies to compensate for excess growth in pharmaceutical purchases and to encourage more use of generic drugs. However, the government will avoid implementing excessively stringent measures to limit pharmaceutical spending during the forecast period, as it aims to maintain the presence of a substantial pharmaceutical sector in the country.

Patients are free to choose their own doctors, clinics and hospitals and do not require referrals. However, a reform introduced in 2002 has increased fees for direct access to specialists relative to access via referrals by general practitioners. Doctors, most of whom are independent practitioners, are paid on a fee-for-service basis, according to nationally agreed fee schedules. The majority of hospitals are private non-profit institutions, run by charities and religious orders, while others are public. Private profit-making hospitals are rare.

Diseases overview

The main causes of death in Belgium include cardiovascular disorders, neoplasms, respiratory disorders and unnatural causes of death such as accidents and suicides.

Approximately one-quarter of the population reports having at least one long-term illness, a figure that has remained fairly stable since 1997. This suggests that the population ageing that has occurred over the same time period has been characterised by a rise in healthy ageing.

Although not as big a problem in Belgium as in other EU countries such as the UK, the incidence of obesity, particularly among young people, has soared over the past few years. Sedentary lifestyles, high levels of alcohol consumption and poor eating habits are to blame for this substantial increase.

Belgium has had limited exposure to the A(H1N1) virus (swine flu) compared with some other Euro area countries. In late 2009, the country launched a mass vaccination campaign against swine flu, targeting people most at risk such as health workers, children below six years of age, pregnant women and the infirm.