Private expenditure on health and voluntary private health - - PowerPoint PPT Presentation
Private expenditure on health and voluntary private health insurance Piet Calcoen Expenditure on health in the European Union Curative care Pharmaceutical drugs 30% 40% 78,7% 15,3% 1,1% Dental care Therapeutic appliances 18% 4,9% 12%
4,9% 78,7% 15,3% 1,1% Voluntary private health insurance Public expenditure on health Out-of-pocket expenditure on health Other
Pharmaceutical drugs 40% Dental care 18% Therapeutic appliances 12% Curative care 30%
OECD, 2014
Every person should have access to health care on the basis of need and not ability to pay (Oliver and Mossialos, 2004) People’s right to spend their money as they choose (Richards , 2008)
“It is impossible to imagine a situation where the rich could spend as much as they like on buying a villa, but could not spend their money in order to get something which affects them most, namely, their own health care.”
26 % of Belgian households: « out-of-pocket expenditure on health is (very) hard to bear » 46 % of Belgian households with chronically ill members need to postpone health care for financial reasons 25 % of cancer patients pays privately 2844 EUR per year or more
« cancer poverty »
Belgium; Belgian Health Interview Survey (2013); Samana, 2016; Rommel, 2015; Lewis, 2017
OECD Health Statistics version 2018; RIZIV/INAMI, 2018; CM, 2017; National Accounts, 2017
2 174 million EUR 479 million EUR 1 293 million EUR 2 554 million EUR
OECD alternative calculation OECD alternative calculation
Health expenditure as a share of GDP
2,7%
Netherlands 10,4%
0,8%
Belgium 10,0% Residential long-term care facilities
OECD Health Statistics version 2018 (figures for 2016)
coverage of health expenditure other than hospitalisation costs, should be developed and promoted.
60 357 1866 717 784 1310 2174 1293
Hearing aids*** Optical glasses and other vision products*** Pharmacies** Psychologists, dietitians, fysiotherapists (ambulatory)*** Dental practices (ambulatory)** Medical practices (ambulatory)** Residential long-term facilities* General hospitals*
*Alternative calculations (figure for 2016) **OECD Health Statistics version 2018 (figure for 2016) ***Alternative calculations (figures for 2010)
Regulate (cf. Germany) Create private convention Cut link with private room
Replace by link with the convention status of the physician
Strict convention system: Only non-conventioned physicians are allowed to charge supplementary fees. Conventioned physicians get substantial social security benefits (cf. France).
Private practice two days per week (covered by private health insurance) + social security practice three days per week.
Physicians are free to set their fees but without reimbursement by mandatory basic health insurance.
health insurance can play a complementary role in providing access to new health technologies.
Waiting room function ➢ second cochlear implant ➢ tantalum hip prosthesis ➢ robotic prostate surgery Not reimbursed by mandatory basic health insurance ➢ computerized artificial limb
(Belgium; Knack, 21 May 2014)
physiotherapy can be excluded from mandatory basic health insurance - except for certain target groups- and covered by voluntary private health insurance.
https://www.bundesgesundheitsministerium.de/fileadmin/Dateien/5_Publikationen/Praevention/Berichte/IGES_Gutachten_KfO.pdf
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