UHC Belgium. Dr Ignace RONSE

Transcription

1 UHC Belgium Dr Ignace RONSE

2 Plan 1. Health Coverage in Belgium 2. UHC in Belgian Development Cooperation 3. Support to Health Coverage in Belgian Development Cooperation programme in Peru

3 Health Coverage in Belgium 1. Organizing the system 2. Financing the system 3. Lessons learnt

4 Organizing the system 1. Belgian Federal Public Service Health, Food Chain Safety and Environment: National Health Insurance Institute 2. Mutualities: compulsory but active choice 3. Health services & professionals (public or private but agreed tarification and no profits allowed for the institutions) Regular dialogue health universities 99% is covered: very broad benefits package One single social (non commercial) system.

5 Financing the system (2012) 1. GNI: 377 billion 2. State Budget: 150 billion 3. Health expenditure: 32 billion: 32 million consultations 5 million hospitalisations (means 5 day stay).

6 Financing the system The reimbursement of health services depends on type of service provided, income and social status of the patients accumulated amount of co-payments already paid for that year. For more vulnerable population groups, several measures were taken to ensure their access to high-quality care.

7 Financing the system (2012)

8 Financing the system (2012)

9 Historic perspective : Voluntary insurances by mutualities Progressive organisation and progressive advocacy Compulsory adhesion Solidarity through state financing Equitable qualitative services requires a single and controlled system and a dialogue with the Human RH Cooperation: criteria to achieve equitable access to qualitative health services funded on a base of solidarity Voluntary can t achieve equity Compulsory without trust can t achieve universality Trust requires qualitative services and social dialogue

10 Achieving equity? Persistent health inequities: Health is determined by a clear social gradient and improves as socioeconomic status improves. People in the weakest socioeconomic groups live less long and spend fewer years in good health.

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14 Lessons learnt The Belgian Federal Public Service Health, Food Chain Safety and Environment participates in the Joint Equity action of the European Commission in order to increase its capacity to tackle health inequities more effectively. inform of the existing health inequities and their most important determinants, underline the importance of intersectoral / cross-governmental work to tackle health inequities.

15 Lessons learnt Main results of the policy dialogue: Implementation of Health in All Policies is needed to tackle health inequities Creation of a Interdepartmental Working Group on health inequities (Commission for Sustainable Development) Development of a national action plan on health inequities Translate the recommendations of the WHO Report on social determinants of health and the health divide in the WHO European Region to the Belgian context Designate a contact person at all levels of government to increase capacity building, raise awareness and improve involvement regarding health inequities

16 UHC in Belgian Development Cooperation Health in the Belgian Development Cooperation The Policy note on UHC

17 Health in the Belgian Development Cooperation 1. GNI 377 billion (2012) 2. State budget 150 billion 3. Development Cooperation 1.8 billion (0.47% of GNI) 4. DGD 1 billion Belgium is committed to spend 0.7% of its GNI to development cooperation. About 13% of this share (which corresponds to 0.1% of its GNI) is aimed at strengthening universal health coverage to contribute to bridge the gap between the current national health budgets in the low income countries (25$ per inhabitant) and the needs (54$ per inhabitant).

18 Health in the Belgian Development Cooperation ODA contributions from DGD 10,06% 11,22% 12,19% 10,90% 14,25%

19 Policy Note: Universal Health Coverage: contributing to The right to health and healthcare services

20 Plan Definition Challenge Role of the Belgian Development Cooperation

21 Definition Equal access to essential quality healthcare services Embedded within social protection and a range of social and economic criteria WHR 2010

22 Role of the Belgian Development Cooperation Support to elaborating and implementing a strategic plan - Trace the pathway of universal coverage - Intersectoral approach to influence the social criteria of health - Start from local analysis

23 Role of the Belgian Development Cooperation (continued) Bridge the gap between the local, national and international level Facilitate the dialogue and bring together policy makers, local actor and researchers Keep up national budgets (for health care in the South and for development in the North): 0.7%, innovative taxes)

24 Coherent support to UHC programme in Peru Expertise: 1) Social and political consensus 2) Mutualities (active participation & democratic management) 3) Scientific expertise. Support to OMS Support SIS: ensure access for the population to comprehensive quality health care services with emphasis on the most vulnerable population - SIS-FIN: Technical support - SIS-TEC: Budget support Instit. Medecina Tropical (Universidad Cayetano Heredia) FOS

25 Conclusion Achieving equitable access to qualitative health services funded on a base of solidarity is not easy, requires a long process and is different in every country Nevertheless there are some communalities: Compulsory adhesion State participation in the financing is paramount Single social (non commercial) comprehensive system Control is necessary (quality, generics ) Dialogue with civil society and Human Resources

26 Thank you for your attention! Les agradezco mucho por su atención!