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Health care reform in Belgium

Author

Listed:
  • Erik Schokkaert

    (Centre for Economic Studies, Naamsestraat 69, Leuven, Belgium)

  • Carine Van de Voorde

    (Centre for Economic Studies, Naamsestraat 69, Leuven, Belgium)

Abstract

Curbing the growth of public sector health expenditures has been the proclaimed government objective in Belgium since the 1980s. However, the respect for freedom of choice for patients and for therapeutic freedom for providers has blocked the introduction of microeconomic incentives and quality control. Therefore - with some exceptions, particularly in the hospital sector - policy has consisted mainly of tariff and supply restrictions and increases in co-payments. These measures have not been successful in curbing the growth of expenditures. Moreover, there remains a large variation in medical practices. While the structure of health financing is relatively progressive from an international perspective, socioeconomic and regional inequalities in health persist. The most important challenge is the restructuring of the basic decision-making processes; i.e. a simplification of the bureaucratic procedures and a re-examination of the role of regional authorities and sickness funds. Copyright © 2002 John Wiley & Sons, Ltd.

Suggested Citation

  • Erik Schokkaert & Carine Van de Voorde, 2005. "Health care reform in Belgium," Health Economics, John Wiley & Sons, Ltd., vol. 14(S1), pages 25-39.
  • Handle: RePEc:wly:hlthec:v:14:y:2005:i:s1:p:s25-s39
    DOI: 10.1002/hec.1027
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    File URL: http://hdl.handle.net/10.1002/hec.1027
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    References listed on IDEAS

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    1. Carine Van De Voorde & Eddy Van Doorslaer & Erik Schokkaert, 2001. "Effects of cost sharing on physician utilization under favourable conditions for supplier-induced demand," Health Economics, John Wiley & Sons, Ltd., vol. 10(5), pages 457-471.
    2. Erik Schokkaert & Carine Van de Voorde, 2000. "Risk adjustment and the fear of markets: The case of Belgium," Health Care Management Science, Springer, vol. 3(2), pages 121-130, February.
    3. Manning, Willard G, et al, 1987. "Health Insurance and the Demand for Medical Care: Evidence from a Randomized Experiment," American Economic Review, American Economic Association, vol. 77(3), pages 251-277, June.
    4. DE GRAEVE, Diana & DUCHESNE, I., 1997. "Equity in health and in medical care consumption in Belgium," SESO Working Papers 1997001, University of Antwerp, Faculty of Applied Economics.
    5. Diana De Graeve & Tom Van Ourti, 2003. "The Distributional Impact of Health Financing in Europe: A Review," The World Economy, Wiley Blackwell, vol. 26(10), pages 1459-1479, November.
    6. Wagstaff, Adam & van Doorslaer, Eddy & van der Burg, Hattem & Calonge, Samuel & Christiansen, Terkel & Citoni, Guido & Gerdtham, Ulf-G & Gerfin, Mike & Gross, Lorna & Hakinnen, Unto, 1999. "Equity in the finance of health care: some further international comparisons1," Journal of Health Economics, Elsevier, vol. 18(3), pages 263-290, June.
    7. Cockx, Bart & Brasseur, Carine, 2003. "The demand for physician services: Evidence from a natural experiment," Journal of Health Economics, Elsevier, vol. 22(6), pages 881-913, November.
    8. Schokkaert, Erik & Van de Voorde, Carine, 2003. "Belgium: risk adjustment and financial responsibility in a centralised system," Health Policy, Elsevier, vol. 65(1), pages 5-19, July.
    9. ADRIAENSSEN, Ines & DE GRAEVE, Diana, 2001. "Wie valt er door de mazen van het net? Verkennend profiel van de patiënt met betalingsproblemen in het ziekenhuis," Working Papers 2001018, University of Antwerp, Faculty of Applied Economics.
    10. van Doorslaer, Eddy & Wagstaff, Adam & van der Burg, Hattem & Christiansen, Terkel & De Graeve, Diana & Duchesne, Inge & Gerdtham, Ulf-G & Gerfin, Michael & Geurts, Jose & Gross, Lorna, 2000. "Equity in the delivery of health care in Europe and the US," Journal of Health Economics, Elsevier, vol. 19(5), pages 553-583, September.
    11. Van der Heyden, J. H. A. & Demarest, S. & Tafforeau, J. & Van Oyen, H., 2003. "Socio-economic differences in the utilisation of health services in Belgium," Health Policy, Elsevier, vol. 65(2), pages 153-165, August.
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    Citations

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    Cited by:

    1. Holst, Jens, 2010. "Patient cost sharing: Reforms without evidence. Theoretical considerations and empirical findings from industrialized countries," Discussion Papers, Research Group Public Health SP I 2010-303, Social Science Research Center Berlin (WZB).
    2. Paula González, 2010. "Gatekeeping versus direct-access when patient information matters," Health Economics, John Wiley & Sons, Ltd., vol. 19(6), pages 730-754.
    3. Erik Schokkaert & Tom Van Ourti & Diana De Graeve & Ann Lecluyse & Carine Van de Voorde, 2010. "Supplemental health insurance and equality of access in Belgium," Health Economics, John Wiley & Sons, Ltd., vol. 19(4), pages 377-395.
    4. Eva Lefevere & Niel Hens & Frank Smet & Philippe Beutels, 2016. "The impact of non-financial and financial encouragements on participation in non school-based human papillomavirus vaccination: a retrospective cohort study," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 17(3), pages 305-315, April.
    5. repec:eee:hepoli:v:121:y:2017:i:11:p:1169-1176 is not listed on IDEAS
    6. Garattini, Livio & Cornago, Dante & De Compadri, Paola, 2007. "Pricing and reimbursement of in-patent drugs in seven European countries: A comparative analysis," Health Policy, Elsevier, vol. 82(3), pages 330-339, August.
    7. Perelman, Julian & Closon, Marie-Christine, 2007. "Hospital response to prospective financing of in-patient days: The Belgian case," Health Policy, Elsevier, vol. 84(2-3), pages 200-209, December.
    8. Léonard, Christian & Stordeur, Sabine & Roberfroid, Dominique, 2009. "Association between physician density and health care consumption: A systematic review of the evidence," Health Policy, Elsevier, vol. 91(2), pages 121-134, July.
    9. GONZALEZ, Paula, 2003. "The "gatekeeping" role of general practitioners. Does patients' information matter ?," CORE Discussion Papers 2003089, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
    10. repec:spr:eujhec:v:19:y:2018:i:2:d:10.1007_s10198-017-0874-x is not listed on IDEAS

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