Belgium Region

Medium HALE and Life Expectancy
High Gap between HALE and Life Expectancy

Final Longevity Progressiveness Ranking:#25

Final Longevity Progressiveness Score: 0.655

Practical Recommendation Summary: There are disparities in unmet care needs by income group. As cardiovascular diseases and cancer are the leading causes of death, the challenge is to strengthen prevention and primary care.

Practical Recommendations (Full):
● Move to a life-course perspective in tackling the rising epidemic of “metabesity.” Initiate strategies to improve the health of the nation, promote the importance of focusing on socio-demographic factors to ensure delivery of healthy newborns and decrease the burden of behavioural factors such as insufficient physical ability, overweight, alcohol abuse, smoking. This will stimulate policy initiatives that supplement income and improve educational opportunities, housing prospects, and social mobility as income is strongly associated with morbidity and mortality.
● Investments into the new progressive ways of medical treatment. Development of new medicines and innovative approaches to treatment will solve the problem of enormous antibiotic consumption and make treatment even more effective leading to sufficient improvements in health status.
● Make healthcare more affordable by spending more costs on public medicine. The public sector in Belgium is developed enough but still, it is just subsidized, that means the public sector covers only part of expenses on healthcare services. The share of out-of-pocket payments in current healthcare expenditures is high which cause a financial burden on low socio-income groups.
● Initiate social protection programmes to reduce high disparities in health status. Currently, people with a higher socioeconomic status (SES) live longer. The gap in life expectancy (at age 25) between the highest and lowest educational levels is 6.1 years for men and 4.6 years for women. People with higher SES also live longer in good health. The gap in health expectancy without disability (Healthy Life Years) between the highest and lowest educational levels is 10.5 years for men and 13.4 years for women. The gaps in health expectancy have increased over time.
● Support development of the pharmaceutical industry and utilizing AI opportunities for drug discovery. Artificial intelligence can improve efficiency and outcomes in drug development across therapeutic areas.

SWOT Analysis

Strengths:
● Low amenable mortality.
● Nearly universal compulsory health insurance.
● The quality of acute care for cardiovascular diseases is better than the EU average.
● High quality of cancer care.
● Simplified measures to reduce the impact of co-payment for vulnerable groups.
● eHealth helps to manage operations quickly and struggles the bureaucracy.
● Even expats entitled to the universal healthcare system.

Weaknesses:
● Increasing behavioural risks: regular heavy alcohol consumption in adults is above the EU average, increasing obesity.
● Large inequalities in life expectancy by socioeconomic status.
● Too high antibiotic consumption.
● Cigarette consumption is above the EU average and is very high.
● Belgium medical system is relatively high costed.
● The outcomes of Belgium healthcare system are lower than in other developed countries.

Opportunities:
● Improve prevention and primary care through utilizing modern technologies and applying modern concepts in healthcare, such as P4 Medicine
● Reducing cancer mortality through early detection and greater prevention.
● Improve hospital efficiency.
● Generate additional databases on health through voluntary patients’ contributions.
● Residents have full flexibility in choice of private insurance provider.Threats:
● Reduced growth in public spending on health.
● Shortage of health professionals, in particular doctors.
● Behavioural factors can shorten life expectancy and healthy years of life.
● Unemployed population, students, pensioners etc have the same subsidies as a working population that borns a disbalance in the system.
● The public healthcare in Belgium is not fully free, it is partly subsidized, so most of patients purchase additional private insurance.

SWOT Conclusions

Strengths Analysis:
● Belgium ranked fifth in the 2018 Euro Health Consumer Index.
● Belgium spends 10% of its annual GDP on healthcare expenditure, according to 2016 figures. This places it ninth out of countries from the EU and European Free Trade Association (EFTA). This indicator is higher than the EU average.
● Economic stability, good infrastructure for healthcare, progressive effective medicine and ability to pay for medical help to increase the life expectancy and HALE.
● Health insurance contributions are 7.35% of gross salary (3.55% from salary; 3.8% paid by the employer).
● Long-term care policy has for a long time aimed at developing care services at home to postpone institutionalisation of elderly people as much as possible. Funding for care at home has increased significantly.

Weaknesses Analysis:
● Dental services can be not covered by basic health insurance and can be expensive enough.
● Dramatical behavioural factors which mean high cigarette and alcohol consumption, fat and unhealthy food popularisation that can decrease the life expectancy and healthy years of life.
● Hospital stay and treatment can cost high and insurance can not cover some of the services so patients usually need to make out-of-pocket spendings on, for example, daily care and some medicine.
● Only prescribed medicines are refunded, those non-prescribed are bought by patients. Some medications are reimbursed fully, while others only up to 20%.
● Smoking, alcohol, fast food consumption and lack of physical activities are the major causes of the diseases, especially, chronic one that can be the reason for a decrease in longevity.
● Ischemic heart disease, Alzheimer and stroke are the top reasons for death in older age.