Belgium's Minister of Health, Frank Vandenbroucke, is working on capping additional healthcare fees by 2028.
Doctors who are registered with the national health insurance system adhere to the rates agreed every two years with the health insurance funds.
Nonetheless, many healthcare providers are not registered and can charge additional fees, for which there is currently no maximum ceiling.
Vandenbroucke (Vooruit) is therefore working on establishing a maximum ceiling. For outpatient care – patients who are not admitted to the hospital – this ceiling will be 25% of the fee. For patients who are admitted to the hospital – for daycare or overnight stays – it will be 125% of the fee.
Those who are entitled to increased compensation do not currently have to pay any supplements. The restrictions are due to come into force on 1 January 2028.
"The supplements in healthcare are rising year after year, without much logic, and are increasing the patient's bill," said Vandenbroucke.
The system also makes hospital bills unpredictable, he added: for a hospital birth with a stay in a single room, for example, the fee supplement could vary from €219 to €2,199 in 2021, with a few outliers even reaching €7,000, the minister estimated based on figures provided by the health insurance funds.
The maximum ceiling on fee supplements is part of a broader reform bill, which, according to Vandenbroucke, is intended to keep healthcare accessible and affordable. The aim is to encourage doctors to sign up for the agreement by only giving certain premiums for things such as practice support to those who do so.
In addition, a "fallback position" will be introduced in case doctors and health insurance funds fail to reach an agreement on rates. This means that the Minister of Health will then be able to make the final decision. There will also be more opportunities to call out doctors who abuse the health insurance system, and the digitisation of healthcare will be accelerated.
In parallel, Vandenbroucke has been working for some time on a reform of the nomenclature and hospital reform. He wants to separate the reimbursement for actual care tasks from the operating costs for care providers, with supplements only being possible on top of the reimbursement for the former. Hospitals would then have their operating costs covered directly.
It remains to be seen whether coalition partner N-VA will simply agree to the minister's plans. Member of Parliament Kathleen Depoorter (N-VA) has indicated on social media that this is an "unvalidated text" by Vandenbroucke that does not correspond to what is stated in the coalition agreement.
