Belgium

The western European nation of Belgium has one of the highest standards of living in the world, and the United Nations Development Programme Human Development Reports rank Belgium 14th among the world's nations in general quality-of-life issues. Health-care coverage is universal, but Belgians have the freedom to choose supplementary coverage if desired. All hospitals receive government subsidies. The private sector plays only a minor role in healthcare in Belgium. With a per capita income of $31,100, Belgium is the 21st richest country in the world. Income is relatively [Page 217]evenly distributed, and Belgium ranks 25 on the Gini index of inequality. The richest 10 percent of the population claim 23 percent of the wealth, and the bottom 10 percent share 3.2 percent. However, poverty (4 percent) and unemployment (8.4 percent) do exist.

Belgians have a strong safety net, and health coverage is required by law. As the population ages, healthcare becomes a heavier burden for the government, and the Silver Fund was set up in 2001 to create a future reserve so that all Belgians will continue to receive quality healthcare and be able to enjoy a reasonable standard of living. The current health system had its roots in the post–World War II period. In 1963, the health system was overhauled with Le-burton's Law, which created the National Institute for Sickness and Invalidity. Physicians were so enraged by the pay schedule set up in Leburton's Law that they went on strike in March 1964. Negotiations led to modifications to the schedule, and the strike ended in June 1964. All Belgian workers are covered through insurance programs, and public assistance, which includes health coverage, is available for those who need it. New parents may receive a birth grant or an adoption allowance. Financing involves collecting contributions from both employers (34 percent) and employees (13 percent). Self-employed Belgians are also covered, with contributions to the program based on income. Costs for healthcare and medications are either fully or partially refunded, according to an established rating system.

To plan ahead for the needs of its aging population, the Belgian government set up a special healthcare fund in 2001.

Belgium's commitment to healthcare leads to 9.4 percent of the total Gross Domestic Product (GDP) being expended on health. Approximately $2,828 per capita is targeted for government healthcare programs. Some 67.2 percent of all health expenses derive from government funding, and 88.4 percent of that amount is targeted for social security. The private sector contributes 32.8 percent of spending on healthcare, and 66.60 percent of that amount comes from out-of-pocket expenses. There are 4.49 physicians, 5.83 nurses, 0.64 midwives, 0.81 dentists, and 1.14 pharmacists per 1,000 population in Belgium.

Belgium's population of 10,379,067 enjoys a life expectancy of 78.77 years, with females outliving males by an average of six years. This rating places Belgium 35th in the world in life expectancy. Literacy is virtually universal (99 percent). Primary school enrollment is 100 percent, and secondary school enrollment is in the high 90s. All Belgians have access to safe drinking water and improved sanitation. Over 70 percent of women use birth control, and the fertility rate is 1.64 children per female. All births are attended by trained personnel, and antenatal care is universally available. The maternal mortality rate is 10 deaths per 100,000 live births.

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