78
HiT in Belgium
Public spending as a percentage of the GDP (1)/GDP
–
6.4
KCE Reports 138
–
6.6
–
7.1
–
6.9
Source: National Bank of Belgium, National Institute of Statistics, NIHDI-RIZIV-INAMI, Mutual Health Fund Control Office, Insurance Control Office, National Accounts, household budget surveys, ANMC data and own calculations based on a methodology developed by Avalosse 2009. Note: *Until 2003, the FPS Health, Food Chain Safety and Environment partially funded the per diem charges for hospitalizations. From 2004, the operating hospitals’ budgets are fully funded by the NIHDI.
Fig. 3.5: Percentage of total expenditure on health according to source of revenue, 2006
Because of a different method compared to the System of Health Accounts (SHA), total health expenditures as a percentage of the GDP presented in Table 3.3 differ from those in Table 3.1.
3.3
POPULATION COVERAGE AND BASIS FOR ENTITLEMENT
3.3.1
Coverage
3.3.1.1
Breadth: who is covered? Almost 99% of the population is covered by the compulsory health insurance. There are two main schemes: (1) the general scheme for the whole population except for the selfemployed, and (2) the scheme for the self-employed. The general scheme covers a large but limited number of categories of people such as employees, employees in incapacity, the unemployed, retired people, widows, orphans, students, residents and so on. Residents are defined as people who are registered in the Belgian National Registry. Since 1 January 2008, both major and minor risks are covered by both schemes.o Major risks include hospital care, delivery of babies, major surgery, dialysis functional rehabilitation care, implantable medical devices and specialist care, among others. Minor risks include physicians’ visits, dental care, minor surgery, home care and pharmaceuticals for outpatient care, among others. The basic principle for health insurance coverage is that people benefit in accordance with their actual or past professional activity. Both active and non-active people, as well as their dependants are covered. The main insured members are entitled to health insurance on the basis of their current or previous profession. Dependants are covered based on their relationship with the main entitled person, that is, a member of the family of the entitled person living in the same main place of residence. In 2008, over 9.4 million people (88.5%) were insured under the general scheme and over 1 million (9.7%) under the scheme for the self-employed (NIHDI 2008a).
o
In the past, both major and minor risks were covered for people in the general scheme and only major risks were covered for the self-employed.