Belgium HiT (2020)

Belgian residents are covered for a wide range of health services

The Belgian health system covers almost the entire population for a wide range of services. The main source of financing is social contributions, proportional to income. The provision of care is based on the principles of independent medical practice, free choice of physician and care facility, and predominantly fee-for-service payment.

Health expenditure in Belgium is high at over 10% of GDP

Health expenditure in Belgium has increased over the past two decades and has stabilised around 10% of GDP since 2009. Current health expenditure as a share of GDP was 10.3% in 2017 (8th highest among countries in the WHO European Region), and expenditure per capita was US$PPP 5119. The public share of current health expenditure was more than three-quarters (77.2%) in 2017, while most private health financing comes from households’ out-of-pocket payments for non-reimbursed services, official co-payments and extra-billings.

Belgians enjoy good health and access to high quality health services

The Belgian population enjoys good health and long life expectancy. This is partly due to the population’s good access to many high-quality health services. However, some challenges remain in terms of appropriateness of pharmaceutical care, reduced accessibility for mental health and dental care due to higher user charges, socioeconomic inequalities in health status and the need for further strengthening of prevention policies. The system must also continue to evolve to cope with an ageing population, an increase of chronic diseases and the development of new technologies.

There remains a continued focus on improving the quality of care and efficiency of the health system

The most important reforms since 2014 concern the transfer of additional health competences from the Federal State to the Federated entities, the plan to redesign the landscape of hospital care, and the modernisation of the regulation of health professionals. Policymakers have also pursued the goals of further improving access to high-quality services, while maintaining the financial sustainability and efficiency of the system, resulting in the implementation of several measures promoting multidisciplinary and integrated care, the concentration of medical expertise, patient care trajectories, patient empowerment, evidence-based medicine, outcome-based care and the so-called one health approach.