THE ROLE OF THE SICKNESS FUNDS IN THE BELGIAN HEALTH-CARE MARKET

This article reviews some of the salient features of the Belgian healt h care finance and delivery system. Special attention is paid to the r ole played by the third-party payers, i.e. the Health Insurance Associ ations (HIAs) in administering the compulsory national health insuranc e program. It is shown how, despite extensive government regulation, t he markets for GP, specialist and hospital services exhibit fierce com petition of the non-price variety. Next, the paper considers the three problems perceived to be the most pressing ones at present: (i) the p roblem of raising sufficient revenues to cover the public share of hea lth expenditures; (ii) the (related) cost containment problem; and (ii i) the problem of ensuring efficiency through appropriate incentive me chanisms. Finally, two recently proposed options for reform are discus sed and complemented with a third proposal based on the ideas of regul ated competition. It is concluded that strengthening the role of the t hird-party payers remains crucial in any attempt to reshape the system to make it efficient and affordable while keeping it equitable.