WHO: ‘serious concern’ over Belgium’s high rates of out-of-pocket health spending

Belgium has among the highest rates of catastrophic personal health spending in western Europe, finds a report out Tuesday from the World Health Organization’s Europe office.

That means that households’ out-of-pocket health spending is so high that they can no longer afford basic needs, such as food, housing and heating.

One in 20 Belgian households in 2020 experienced financial hardship due to out-of-pocket payments for health care, said WHO Regional Director for Europe Hans Kluge. "That is a serious concern,” added Kluge, who is himself Belgian, in a statement.

The causes vary across the population. On average, it is driven by the cost of medical products such as glasses and hearing aids, as well as by inpatient care. But in the case of poorer households, the researchers find catastrophic spending is mainly due to the cost of outpatient care, medicines and diagnostic tests.

“Most outpatient care is subject to retrospective reimbursement rather than provided as a benefit in kind, which is highly unusual among health systems in high-income countries,” the report states.

Though the authors recognize the government’s moves to improve the situation — such as freezing of the annual co-payments limit and the extension of coverage for dental care — obstacles remain, it says.

The WHO/Europe provides many recommendations, such as scrapping retrospective reimbursement for all health services and sparing low-income households from all co-payments.