Health System Performance Assessment: how equitable is the Belgian health system?

KCE Reports 334C (2020)

Unfortunately not everyone is in good health and some people need to have recourse to healthcare more than others. In our Belgian system, which is based on solidarity, efforts are made to reduce these inequalities as far as is possible. But when you look at people who have the same healthcare requirements, can we say that the ease with which they can access that healthcare is the same for all of them? In other words, is access to our healthcare system equitable? We used an innovative method in an attempt to answer this question. It emerges from this that for households in a situation of financial insecurity access to healthcare is not equitable, in particular access to specialists and dentists, to the extent that some of them put off this care or do not have recourse to it at all. The main reason is the amount the patient has to pay out of his own pocket or has to pay in advance. For 4% of households, healthcare expenses even represent more than 40% of their total expenses. Protection measures exist, such as the higher reimbursement rates (preferential reimbursement beneficiaries). They do indeed make it possible to reduce these cases of injustice, but protection could be further enhanced as far as the patient’s contribution towards the cost of medical treatment is concerned or in the field of additional charges, the amounts of which are increasing.