International Handbook of Medical Education

By Abdul W. Sajid; Christine H. McGuire et al. | Go to book overview

4
Belgium

L. CASSIERS

Belgium is a small European country whose geographic location has laid it open to foreign influences throughout its history, resulting in a long-standing outward- looking tradition. The country's population is characterized by multiple philosophical and linguistic backgrounds. Belgium has both French and Dutch- speaking populations, which has created an atmosphere conducive to competition and creativity.


OVERVIEW OF THE HEALTH CARE DELIVERY SYSTEM

Belgium s health care system is based on the principle of compulsory insurance. All individuals are required to pay a percentage of their income in social insurance contributions and must register with a sickness insurance fund. The fund reimburses individual health care expenditure according to tariffs set by the national government. The sickness insurance funds are not private insurance companies in the commercial sense. They are strictly regulated by a lengthy series of statutes, and in fact, they are, to a large extent, the creatures of (and have many de facto links with) political parties and trade unions.

The doctor-patient relationship is governed by the principle of freedom of choice. Individuals consult the practitioner of their choice, while doctors are free to charge the amount they see fit. In practice, however, the surplus of medical practitioners means that the vast majority of doctors apply the scale of charges recommended by the state in order to maintain the size of their practice. The same applies to the hospitals, which are noncommercial bodies bound to the state under detailed contracts stipulating compliance with the scale of charges.

The rates of reimbursement of health care expenditure are fixed under collective agreements between the doctors' professional association, insurance funds, and the state, one of whose obligations is to underwrite any losses incurred by the system. In essence, health care is a semi-state-run system. Individuals have freedom to choose their doctor and receive virtually free treatment with no

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International Handbook of Medical Education
Table of contents

Table of contents

  • Title Page iii
  • Contents v
  • Illustrations ix
  • Foreword xi
  • Preface xv
  • 1: An Overview of Medical Education in the Late Twentieth Century 1
  • References 12
  • 2: Evaluation and Change in Medical Education 13
  • References 18
  • 3: Australia 21
  • References 35
  • 4: Belgium 37
  • References 48
  • 5: Brazil 53
  • 6: Canada 65
  • References 75
  • 7: The Commonwealth (English-Speaking) Caribbean 81
  • References 96
  • 8: Chile 101
  • References 107
  • 9: The People's Republic of China 109
  • References 123
  • 10: Czech and Slovak Federative Republic 131
  • References 139
  • 11: Egypt 141
  • References 154
  • 12: France 155
  • References 169
  • 13: Germany 175
  • References 186
  • 14: Hungary 191
  • References 203
  • 15: India 207
  • References 219
  • 16: Israel 231
  • References 246
  • 17: Italy 249
  • References 254
  • 18: Japan 259
  • References 267
  • 19: Malaysia 275
  • References 288
  • 20: Mexico 291
  • References 300
  • 21: The Netherlands 305
  • References 317
  • 22: Nigeria 321
  • References 327
  • 23: Pakistan 331
  • References 342
  • 24: Poland 347
  • References 358
  • 25: Russia (Former USSR) 359
  • References 368
  • 26: South Africa 369
  • 27: Thailand 377
  • References 390
  • 28: United Kingdom 393
  • References 403
  • 29: United States of America 405
  • References 415
  • 30: Venezuela 417
  • References 428
  • Appendix A: General Country Demographics, 1989 437
  • Appendix B: Medical School Demographics, by Country 441
  • Appendix C: Admission Policies and Requirements, by Country 447
  • Appendix D: Policy Making Bodies with a Role in Medical Education 459
  • Appendix E: Professional Organizations with a Role in Medical Education, by Country 465
  • Appendix F: Governmental Agencies with a Role in Medical Education, by Country 469
  • Appendix G: Selected Bibliography 473
  • Appendix H: Acronyms and Abbreviations Used in This Handbook 485
  • Index 495
  • About the Contributors 511
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