December 15, 2020
03:00
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Is access to our health care equitable? Lower consumption, postponement of care, financial obstacles: a KCE study identifies the obstacles linked to precariousness.
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That’s the concern, with reputations, whether good or bad. They cover everything, at the risk of masking the disparities. Yes, the Belgian health system is of good quality, but it is not without flaws. We thus know – even if in a more confidential way – that his relatively high cost to the patient pushes some to postpone treatment, or even to ignore it.
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The latest study from the KCE, the Federal Center of Expertise for Health Care, comes up with this nail. In his viewfinder, equity. Will two people with the same medical needs have equal access to care, regardless of their socioeconomic status?
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The latest study from the KCE, the Federal Center of Expertise for Health Care, comes up with this nail. In his viewfinder, equity. Will two people with the same medical needs have equal access to care, regardless of their socioeconomic status? Not exactly.
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Poverty makes you sick, disease makes you poor
These two hang out. There is a correlation between an individual’s socioeconomic status and their health. “Poverty makes you sick, illness makes you poor”, collects the KCE. A finding confirmed by Belgian data – let us specify that these date from before the wave of the coronavirus.
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“People at risk of poverty use health care less than the general population“, writes the KCE. This is even more true for those in a situation of material deprivation.
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Less consumption which concerns both general practitioners and specialists and dentists. With one exception: these people turn more to the emergency services. “In order to replace consultations with the doctor, advance the KCE. They should indeed not pay for care immediately.Another explanation: due to postponements of care for financial reasons, it is possible that the health problem ends up requiring an immediate care.
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More and more postponements
Less consumption rhymes with unmet medical needs. From 0.4% in 2008, the share of the adult population reporting such needs rose to 1.7% in 2012, reaching 2.3% in 2016. Dental care follows a similar trend: from 1.6% in 2008 to 3.7% in 2016. Scores worse than the European average. Among the causes cited, the increase in personal financial contributions – with supplements in the lead.
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Belgian patient pays a lot
In Belgium, personal contributions weighed in 2018, some 19% of total health care spending, says the KCE. Far above what neighboring countries practice: 9% in France, 11% in the Netherlands and 12.5% in Germany.
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Also in 2018, the KCE researchers noted, 3.8% of Belgian households have faced so-called “catastrophic” personal contributions, that is, representing more than 40% of total expenditure.
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What avenues for improvement?
Measures to protect vulnerable populations exist, notes the KCE. But are not enough. This is the case withincreased intervention, with positive repercussions. People who benefit from it pay less out of pocket, since they benefit from lighter user fees and thesystematic application of third-party payment at the general practitioner. But, there is a but. “A worrying proportion of people living in poverty do not benefit from this increased intervention”, deplores the KCE, which advocates automatic granting. In addition, the KCE calls for a extension of mandatory third-party payment for specialists and dentists.
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Other recommendations: a better protection against supplements and the establishment of a “poverty impact test”, assessing the effects of any new policy.
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