The World Health Organization (WHO) has revealed that 5.2% of all Belgian households were unable to pay for basic necessities in 2020 due to out-of-pocket health costs. The organisation has drawn particular attention to the burden of these out-of-pocket payments on Belgium's poorest households.
While the country offers mandatory health insurance to cover citizens' medical costs, certain payments are not compensated by insurers, which are known as out-of-pocket payments. These can include the provision of glasses, hearing aids and prosthetics.
A recent report by the WHO's Regional Office in Europe has raised the alarm over the negative impact of these additional costs on Belgian households. The report stated that 260,000 households were unable to pay for other necessities, such as energy, food and heating in 2020 due to out-of-pocket health costs.
Most of those affected were among the poorest 5% of Belgians. 12% of these households were unable to incur the costs of out-of-pocket payments, such as outpatient care and medicine, as well as various tests. Moreover, 8% of households headed by unemployed people were also negatively impacted by these costs.
The WHO attributes the disproportional impact on Belgium's poorest households to the country's complex insurance policy, which does not cover the total cost of health services. The organisation explained that Belgian insurance contains unclear rules regarding copayments, which is the amount owed by patients. Belgium is also one of the few EU Member States to retrospectively reimburse outpatient care.
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In response, the WHO's Regional Director in Europe Dr Hans Kluge has called on the Belgian Government to prioritise "reducing out-of-pocket payments, especially for people with low incomes."
The Belgian Government has already taken some steps to address the issue, which has garnered praise from the WHO. These included establishing fixed co-payments for medical visits, abolishing retrospective reimbursements for low-income citizens and lowering the maximum amount a low-income patient has to pay out of their pocket. The government has also frozen a planned indexation of co-payments in line with the Belgian inflation rate.
On their end, the WHO has also offered its own recommendations. They want retrospective reimbursements to be abolished for all health services, as well as exempting low-income households from any co-payments. The organisation also called for the Belgian State to ensure that all of their citizens are insured and enforce stricter regulations on the price of uninsured treatments.
In any case, the proposals for Belgium will be "useful for other countries in our region working to address their own challenges," according to Dr Natasha Azzopardi-Muscat, Director at the WHO's Regional Office in Europe.