Belgian reform package targets excessive medical fees
The so-called 'summer agreement', reached at 4 a.m. on 21st July - Belgium's National Day - marks a pivotal moment in Belgium's political trajectory, touching pensions, taxation, the labour market and healthcare.
"What we have done in six months has not been seen in terms of reform impact in this century," Prime Minister Bart De Wever said.
A key objective of the proposed healthcare system reform, led by Minister of Health Frank Vandenbroucke (Vooruit), is to make healthcare more affordable and transparent. Part of this involves limiting fee surcharges, the additional amounts some doctors charge patients above statutory tariffs.
Shocked by the bill
In a statement published on the social media platform Facebook, Vandenbroucke argued that "if you are ill, you should be taken care of, without being shocked by the bill afterwards simply because of the hospital you ended up in. We are removing excesses. This makes your bill fairer and more transparent. The right care should not depend on your wallet."
According to an overview published by coalition partner Vooruit, the government is determined to rein in what it calls "excessive and unnecessary" fee surcharges.
While most doctors do not charge extra fees, a minority continue to bill patients above the statutory tariffs, both in and outside of hospitals, leading to sharply unequal treatment and unpredictable medical bills.
In some hospitals, patients may be charged over €2,000 in additional fees for procedures such as childbirth, while in others, no surcharges apply at all. "That's simply unfair," the party states. "And who ends up paying the price? Ordinary people."
Vooruit party leader Conner Rousseau framed the reforms as a necessary intervention to preserve the sustainability of the system.
"We are reforming healthcare to keep it affordable and to improve it for the future. Excessive and unnecessary surcharges that some specialists charge must be eliminated. Because if you need care tomorrow, you should still be able to get it," Rousseau said in a party communication following the agreement.
The agreement confirms that limits on additional fees will apply across all medical sectors and disciplines.
A negotiation period has now begun with representatives of the medical profession to set concrete ceilings on how much doctors can charge above the official rates.
According to Vooruit, this moment represents a "historic turning point." If no consensus is reached, the government has reserved the right to impose limits.
The agreement on surcharges follows a tense negotiation period that led to the first doctors' strike in decades.
Balancing access and autonomy
The reform package reflects a political compromise after weeks of mounting pressure from healthcare professionals. While Vooruit pushed to eliminate excessive billing practices, the New Flemish Alliance (N-VA) insisted that reforms be embedded in a broader structural agenda.
"For N-VA, two principles were non-negotiable: high-quality care for patients and respect for caregivers," said MPs Frieda Gijbels and Kathleen Depoorter in a joint statement. "That's why we fought for a workable compromise that upholds both quality and professional independence."
The agreement enshrines a coordinated approach to healthcare reform, covering not only fee supplements but also hospital financing and medical tariffs (the nomenclature). A revised framework law will be drawn up with a clear timeline to synchronise all three elements.
Gijbels, a practising periodontist, said: "From the very beginning, we advocated for an integrated reform. The sector itself called for reforms to be considered together, and we ensured the voice of doctors was heard, even directly to the minister. These changes must never become a blank cheque."
Depoorter added: "We're pleased that the final law leaves room for dialogue, entrepreneurship, and safeguards the liberal profession. Reforms must benefit both the patient and the care provider."
As part of the broader package, the agreement also scraps the so-called 25% rule, ensuring patients receive equal reimbursement whether they visit a contractual or non-contractual provider. The option of partial contract remains, while mutual health insurers will take on increased responsibility for budget management, rising to €100 million annually by 2029.
Curbing pharma overspending
To rein in the projected 25% growth in pharmaceutical spending, the government will introduce a flat €2 co-payment for certain overprescribed drugs like statins and antacids, while promoting more selective prescribing and stricter fraud controls.
The pharmaceutical industry is expected to contribute half of the required savings, which will be reinvested in underfunded areas such as mental health, dental care, staffing and innovative treatments.
[Edited by Vasiliki Angouridi, Brian Maguire]
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Belgian reform package targets excessive medical fees
Belgium's federal government has unveiled a socio-economic reform package after an all-night negotiating session among senior ministers. Among the agreement's most debated components is the proposed reform of the healthcare system. The so-called 'summer agreement', reached at 4 a.m. on 21st July - Belgium's National Day - marks a pivotal moment in Belgium's political trajectory, touching pensions, taxation, the labour market and healthcare. "What we have done in six months has not been seen in terms of reform impact in this century," Prime Minister Bart De Wever said. A key objective of the proposed healthcare system reform, led by Minister of Health Frank Vandenbroucke (Vooruit), is to make healthcare more affordable and transparent. Part of this involves limiting fee surcharges, the additional amounts some doctors charge patients above statutory tariffs. Shocked by the bill In a statement published on the social media platform Facebook, Vandenbroucke argued that "if you are ill, you should be taken care of, without being shocked by the bill afterwards simply because of the hospital you ended up in. We are removing excesses. This makes your bill fairer and more transparent. The right care should not depend on your wallet." According to an overview published by coalition partner Vooruit, the government is determined to rein in what it calls "excessive and unnecessary" fee surcharges. While most doctors do not charge extra fees, a minority continue to bill patients above the statutory tariffs, both in and outside of hospitals, leading to sharply unequal treatment and unpredictable medical bills. In some hospitals, patients may be charged over €2,000 in additional fees for procedures such as childbirth, while in others, no surcharges apply at all. "That's simply unfair," the party states. "And who ends up paying the price? Ordinary people." Vooruit party leader Conner Rousseau framed the reforms as a necessary intervention to preserve the sustainability of the system. "We are reforming healthcare to keep it affordable and to improve it for the future. Excessive and unnecessary surcharges that some specialists charge must be eliminated. Because if you need care tomorrow, you should still be able to get it," Rousseau said in a party communication following the agreement. The agreement confirms that limits on additional fees will apply across all medical sectors and disciplines. A negotiation period has now begun with representatives of the medical profession to set concrete ceilings on how much doctors can charge above the official rates. According to Vooruit, this moment represents a "historic turning point." If no consensus is reached, the government has reserved the right to impose limits. The agreement on surcharges follows a tense negotiation period that led to the first doctors' strike in decades. Balancing access and autonomy The reform package reflects a political compromise after weeks of mounting pressure from healthcare professionals. While Vooruit pushed to eliminate excessive billing practices, the New Flemish Alliance (N-VA) insisted that reforms be embedded in a broader structural agenda. "For N-VA, two principles were non-negotiable: high-quality care for patients and respect for caregivers," said MPs Frieda Gijbels and Kathleen Depoorter in a joint statement. "That's why we fought for a workable compromise that upholds both quality and professional independence." The agreement enshrines a coordinated approach to healthcare reform, covering not only fee supplements but also hospital financing and medical tariffs (the nomenclature). A revised framework law will be drawn up with a clear timeline to synchronise all three elements. Gijbels, a practising periodontist, said: "From the very beginning, we advocated for an integrated reform. The sector itself called for reforms to be considered together, and we ensured the voice of doctors was heard, even directly to the minister. These changes must never become a blank cheque." Depoorter added: "We're pleased that the final law leaves room for dialogue, entrepreneurship, and safeguards the liberal profession. Reforms must benefit both the patient and the care provider." As part of the broader package, the agreement also scraps the so-called 25% rule, ensuring patients receive equal reimbursement whether they visit a contractual or non-contractual provider. The option of partial contract remains, while mutual health insurers will take on increased responsibility for budget management, rising to €100 million annually by 2029. Curbing pharma overspending To rein in the projected 25% growth in pharmaceutical spending, the government will introduce a flat €2 co-payment for certain overprescribed drugs like statins and antacids, while promoting more selective prescribing and stricter fraud controls. The pharmaceutical industry is expected to contribute half of the required savings, which will be reinvested in underfunded areas such as mental health, dental care, staffing and innovative treatments. [Edited by Vasiliki Angouridi, Brian Maguire]
