OECD Economics Department Working Papers
Working papers from the Economics Department of the OECD that cover the full range of the Department’s work including the economic situation, policy analysis and projections; fiscal policy, public expenditure and taxation; and structural issues including ageing, growth and productivity, migration, environment, human capital, housing, trade and investment, labour markets, regulatory reform, competition, health, and other issues.
The views expressed in these papers are those of the author(s) and do not necessarily reflect those of the OECD or of the governments of its member countries.
- ISSN : 18151973 (en ligne)
- https://doi.org/10.1787/18151973
Belgium: Enhancing the Cost Efficiency and Flexibility of the Health Sector to Adjust to Population Ageing
Belgium has a good record in delivering accessible care, but adaptation to population ageing will be
complicated by the fragmentation of responsibilities in the healthcare system and a strong reliance on
government regulations. The organisation of the system could be rationalised by giving sickness funds a more
active role as promoters of cost-efficiency, better aligning the incentives of the different levels of government
and focussing on medium-term budgeting. At the level of care providers, better information flows and
incentive structures could facilitate addressing practice and efficiency variations and supplier-induced
demand. This notably involves completing the shift to pathology-based budgets in hospitals, more capitation
in the remuneration of doctors and measures to tackle the high spending on drugs. Once incentives for
cost-efficiency are in place, a shift towards a more demand-driven system could be encouraged by phasing
out over-prescriptive hospital regulations. In addition, relative remunerations of doctors should be revised
regularly to ensure an adequate supply per specialty. In long-term care, home care, which is generally
cost-efficient, could be further encouraged by giving more autonomy to patients to organise their care. This
Working Paper relates to the 2013 OECD Economic Survey of Belgium (www.oecd.org/eco/surveys/belgium).
Mots-clés: health, population ageing, Belgium, long-term care, hospital, sickness funds, pharmaceuticals
JEL:
I13: Health, Education, and Welfare / Health / Health Insurance, Public and Private;
I11: Health, Education, and Welfare / Health / Analysis of Health Care Markets;
I18: Health, Education, and Welfare / Health / Health: Government Policy; Regulation; Public Health;
H51: Public Economics / National Government Expenditures and Related Policies / Government Expenditures and Health
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