1% of affiliates generate 30% of expenses
The 4.5% of members (103,500) suffering from diabetes “nibble away” at 12% of the total expenditure of Free Mutualities. The ratio for cancer is 1.4% to 12%, lung diseases 4.6% to 13%, respiratory diseases 16.8% to 41%.
Among the 1% of members (23,000 affiliates) with the highest health expenses, 9 out of 10 (91.2%) have at least one chronic illness and 7 out of 10 have at least two chronic illnesses. This “top 1%” represents 30.3% of compulsory health insurance expenditure.
3% below the target set by the WHO
For chronic diseases, there are many direct causes and a large number of risk factors (hypertension, diabetes, hyperlipidemia) linked to lifestyle (smoking, imbalanced diet, lack of physical activity, alcohol consumption ) and the environment (air pollution, exposure to toxic substances).
Risk factors that should be acted upon well in advance to limit health spending. But in terms of prevention, Belgium is lagging behind: barely 2% of the healthcare budget dedicated to prevention, which is below the 5% objective set by the WHO and the European average. (3%).
“A hidden debt for future generations”
“Prevention like ecological transition does not pay off in politics. Officials find it difficult to invest in projects whose results are expected well after the current legislature. We are building a hidden debt for future generations, whether in terms of health or ecological transition.” regrets Xavier Brenez..
The general director of Mutualités Libres calls for a health prevention policy based on clear, long-term objectives. “These objectives, which go well beyond a single legislature, must be defined in a concerted manner between all levels of power..”
Almost wishful thinking in a system where majorities are asymmetrical, skills scattered between different levels of power…
“The basic debate concerns the mechanisms that we will put in place in a modern federal system so that the different levels of power can work in an efficient and coordinated manner.“, he explains.
For the moment, actions are being implemented in the north and south of the country.but the messages are too diverse and scattered. He Ideally, all healthcare providers should address the same problem and the actions that are carried out should be evaluated, which today is very rarely done..”
40,000 deaths avoided
Improving prevention policy does not have the sole objective of reducing health care spending even if “one euro invested in prevention yields four euros“, recalls Xavier Brenez.
An effective prevention policy targeting the main risk factors (tobacco, alcohol, diet, sedentary lifestyle, air pollution) would prevent the death of 40,000 people each year.
