Demande directe (CEACR) - adoptée 2019, publiée 109ème session CIT (2021)

Convention (n° 130) concernant les soins médicaux et les indemnités de maladie, 1969 - Belgique (Ratification: 2017)

The Committee notes the Government’s first report.

Article 17 of the Convention. Cost sharing for medical care benefits. The Committee notes the information provided by the Government in its report that insured persons have to share in the costs of medical care benefits but that various measures have been adopted by the Government to reduce the cost sharing of broad categories of insured persons, such as ceilings on medical expenses and preferential treatments established for the purpose of offering additional protection to vulnerable people. The Committee further notes from the information provided by the Government in its 46th (2016) and 48th (2018) reports on the application of the European Code of Social Security, as amended by the Protocol (Code), which contains a similar provision, that the rate of cost sharing in the cost of consultations and home visits by general practitioners is 30 per cent and 40 per cent for specialist consultations and that the total amount of cost sharing for dental care may amount to 40 per cent. The Committee observes that such high rates of cost sharing may place a financial burden on ordinary insured persons, who are not subject to ceilings on medical expenses and preferential treatments, and act as a disincentive for those persons to access medical care when in need. Recalling that Article 17 of the Convention requires that the rules concerning cost sharing shall be so designed as to avoid hardship and not to prejudice the effectiveness of medical and social protection, the Committee hopes that the Government will consider reducing the rate of cost sharing or take other measures to ensure that participation in the costs of medical care benefits does not place persons protected in a situation of hardship or prevent them from accessing medical care when needed. The Committee requests the Government to keep it informed in this regard.

Article 27. Funeral benefit. The Committee notes the Government’s indication that in case of death of a person who was in receipt of a sickness benefit, his or her entitlement to benefits paid for incapacity for work ceases and funeral benefits are not granted. The Government further refers to subparagraph (a) of Article 27(2) of the Convention which allows derogation from the provision of funeral benefits where, as in the case of Belgium, a member State has accepted the obligations of Part IV of the Invalidity, Old-Age and Survivors’ Benefits Convention, 1967 (No. 128). The Committee recalls that in accordance with Article 27(2) of the Convention, a member State may derogate from the provision of funeral benefits if along with subparagraph (a), the requirements of subparagraphs (b) and (c) are also met. The Committee further recalls that in accordance with subparagraph (b) of Article 27(2) of the Convention, the above-mentioned derogation is allowed if cash sickness benefits are provided at a rate of not less than 80 per cent of the earnings of the persons protected and if, as per subparagraph (c), the majority of persons protected are covered by voluntary insurance which is supervised by the public authorities and which provides a funeral grant. The Committee requests the Government to indicate whether the requirements specified in subparagraphs (b) and (c) of Article 27(2) of the Convention are met.