Web-economic-crisis-health-systems-and-health-web

Belgium
Irina Cleemput and Carine Van de Voorde
Economic trends
• The Belgian economy contracted in 2009 and the government has run
larger deficits since that time. Overall, the economy has been recovering,
with below average unemployment rates and real per capita GDP growth
returning to pre-crisis levels. Government spending as a share of GDP
has remained high relative to other European countries, which led to
higher deficits beginning in 2009.
• Health as a share of government spending has been stable above the
European average. Public per capita health care spending grew more
slowly in 2010 but continued to show positive growth. OOP expenditure
per capita decreased by 1.6% in 2009 (however, this may reflect, in part,
the inclusion, in 2008, of the coverage of minor health risks for the
self-employed into the compulsory health insurance scheme) (Belgium:
Figs 1 and 2).
Policy responses
Changes to public funding for the health system
• Because of the economic crisis, the compulsory health insurance system
did not transfer revenue to its reserve Fund for the Future (set up to
compensate SHI for population ageing) in 2011 or 2012.
• The usual compulsory health insurance budget cap (the “growth norm”
of 4.5% in real terms plus inflation) was not applied in 2012. The budget
was set at a lower rate of €25.6 billion (€0.2 billion less than in 2011).
• The budget cap was reduced to 2% in 2013 (from 4.5%) and 3% for
2014.
• The share of VAT and tobacco tax revenues earmarked for social security was
increased to limit government subsidies and reduce employer contributions
and labour costs (a gradual increase since 2008).
Changes to health coverage
Population (entitlement)
• Co-payments for dental care services (but excluding orthodontic treatment)
waived from September 2005 onwards for children under 12 years of age. In