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The role of the sickness funds in the Belgian health care market

Author

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  • Nonneman, Walter
  • van Doorslaer, Eddy

Abstract

This article reviews some of the salient features of the Belgian health care finance and delivery system. Special attention is paid to the role played by the third-party payers, i.e. the Health Insurance Associations (HIAs) in administering the compulsory national health insurance program. It is shown how, despite extensive government regulation, the markets for GP, specialist and hospital services exhibit fierce competition of the non-price variety. Next, the paper considers the three problems perceived to be the most pressing ones at present: (i) the problem of raising sufficient revenues to cover the public share of health expenditures; (ii) the (related) cost containment problem; and (iii) the problem of ensuring efficiency through appropriate incentive mechanisms. Finally, two recently proposed options for reform are discussed and complemented with a third proposal based on the ideas of regulated competition. It is concluded that strengthening the role of the third-party payers remains crucial in any attempt to reshape the system to make it efficient and affordable while keeping it equitable.

Suggested Citation

  • Nonneman, Walter & van Doorslaer, Eddy, 1994. "The role of the sickness funds in the Belgian health care market," Social Science & Medicine, Elsevier, vol. 39(10), pages 1483-1495, November.
    • Handle: RePEc:eee:socmed:v:39:y:1994:i:10:p:1483-1495
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    Citations

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    Cited by:

    1. Adam Wagstaff, 2010. "Social health insurance reexamined," Health Economics, John Wiley & Sons, Ltd., vol. 19(5), pages 503-517, May.
    2. Schut, Frederik T. & van Doorslaer, Eddy K. A., 1999. "Towards a reinforced agency role of health insurers in Belgium and the Netherlands," Health Policy, Elsevier, vol. 48(1), pages 47-67, July.
    3. Lisa Colman & Katrijn Delaruelle & Carolien Luypaert & Rebekka Verniest & Piet Bracke, 2021. "Burdens in mental health recovery: Causal beliefs and their relation to stigma and help seeking recommendations," International Journal of Social Psychiatry, , vol. 67(8), pages 992-1004, December.
    4. van Doorslaer, Eddy & Wagstaff, Adam & van der Burg, Hattem & Christiansen, Terkel & De Graeve, Diana & Duchesne, Inge & Gerdtham, Ulf-G & Gerfin, Michael & Geurts, Jose & Gross, Lorna, 2000. "Equity in the delivery of health care in Europe and the US," Journal of Health Economics, Elsevier, vol. 19(5), pages 553-583, September.
    5. Adam Oliver, 1999. "Risk Adjusting Health Care Resource Allocations," Monograph 000452, Office of Health Economics.
    6. Schokkaert, Erik & Van de Voorde, Carine, 2003. "Belgium: risk adjustment and financial responsibility in a centralised system," Health Policy, Elsevier, vol. 65(1), pages 5-19, July.

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