Socialized health insurance

This post is for our american friends 😉
I’m always astonished at the crazy costs for healthcare in USA… After reading BFS health insurance change, I decided to give a look at my healthcare costs in the very socialist Belgium.. And it’s pretty different !

How much it cost ? For 2 adults & 1 baby : 500€ per month

  • A fixed amount is taken from your gross salary for social security. (5% of your gross salary)

  • A fixed amount depending also on gross salary for social security. (70€)

  • Then you have to pay an organization that will manage your reimbursement (a “Mutuelle”). (30€)

  • And most company provide a hospital insurance that cover whenever you have to stay in hospital (30€)

What do you get ?

  • For visit to doctor or specialist, you pay in advance & get a partial reimbursement. In hospital, you show your hospital insurance card and don’t pay anything (the insurance company will send a bill for whatever they don’t cover + 150€) and a lot of preventive “care” have incentives

  • A visit to family doctor is 4€ (paid 24€, 20€ reimbursed)

  • Dentist 10€ (60€ paid, 50€ reimbursed)

  • Pediatrician 13€ (36€ paid, 23€ reimbursed)

  • Scanner 2€ (no typing mistake :)) (50€ paid, 48€ reimbursed)

  • There are incentives to do preventive care, for example, your dental care reimbursement is decreased if you don’t have 1 preventive visit per year to the dentist but you also get 100% reimbursement for a few preventive visit per year (for dietitian,dentist, heart, diabete,allergy…)

  • You get some discount if you register to fitness club or sport club

  • There are lot of benefits for baby, you can loan devices (baby weight, milk extractor, …) for a few €, in case of sickness someone can take care of the baby at home

What about staying in hospital ???

  • Whenever you have to stay overnight in a hospital, the hospital insurance kick-in immediately and nothing has to be paid in advance. You show your insurance card, the hospital contact the insurance company and send them the bill afterward. The insurance covers everything and then send you a bill describing the cost and a 150€ co-pay

  • For the birth of our daughter, my wife stayed in a single room for 5 days, getting food and I was able to stay at night in the room (a folding bed was provided). Total cost : 150€… But we got 350€ of birth gift from social security, 1000€ from government and 10 session of massage/osteopathic for the wife/baby (more details coming in another post :))

  • This year the baby got pneumonia and had to stay 4 days in hospital, same 150€

Availability ?

If it’s so cheap to go to doctor or hospital, it’s probably crowded or impossible to get an appointment ! Well… Not really, the 2 times we went to emergency (in different hospital), someone was taking care of us very quickly and the standby doctor arrived less than 10 minutes later.
Getting an appointment to the dentist or other specialist can require to wait a week or two (if you need a specific slot). But there are some 24/7 emergency center where you can go without appointment and get a doctor after waiting around 1 hour (or much less at 3am as I tried for teeth pain)

Conclusion

What is the consequence of having this kind of coverage ? We don’t worry at all about healthcare. We are not cash-tight, so we can handle a 100€ fee here and there, knowing that we will get reimbursed 80% the next month. If anything bad happen and staying in hospital is required, we know that the maximum we will pay is 150€. And getting a baby is not a financial hurdle as birth costs are also capped at 150€ :)
One smart thing is that there is a big focus on preventive care and incentives to stay in good health.

We are young and in relative good health, Don’t we want cheaper costs ?? If the healthcare was less “socialized” we would probably get a cheaper cost but a significant amount of people would pay much more. One thing is the scale savings that a country-wide system is having (there is 0 budget for advertising, every doctor use the same base rate). And another important point is that people got incentives to stay in good health, so the overall consequence is that the population is doing more routine exam and much less emergency financially breaking procedures.
A quick comparison (using OECD data statistics)

Statistics Belgium USA
Health expenditure in % of GDP 10.5% 17.6%
Number of physicians per 1000p 2.9 2.4
Number of nurses per 1000p 15.1 11
Hospital beds per 1000p 6.5 3.1
Doctors consultations 7.3 3.9
Infant mortality rate, deaths per 1000 3.5 6.1

You can find out some interesting data : OECD health data FAQ

2 thoughts on “Socialized health insurance

  1. Hey there !

    I was wondering if the stats take in account the surplus/deficit of the healthcare system. For example, I’m often hearing in France about the deficit of the social security. So maybe a part of the cost is a bit invisible…

    • That’s a good point Christophe :)
      The costs are in percentage of GDP so if the healthcare system use debt to fund itself, it doesn’t change the global cost.
      But it does matter in terms of sustainability.
      I checked for France, the deficit of the social security (not only healthcare but also pensions) should be around 7 billions € (so around 0.4% of GDP)
      For Belgium the deficit of the healthcare is 634 millions € so 0.13% of GDP. Overall that doesn’t change the picture

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