The BVAS medical union opened the debate this week on the status of the compensation increase. According to the union, the group entitled to this has become very large, and retirees in particular are putting pressure on the social system. CM Health Fund disagrees with this conclusion and points to another phenomenon. “In recent years, we have seen more and more young people from big cities ending up in the danger zone.”
In twenty years, the number of Belgians entitled to the increased bonus has risen from 1.3 million to 2.2 million. “In other words, one in five Belgians has the classification of ‘financially vulnerable patient’, which entitles them to lower co-payments and other benefits,” says the BVAS doctors’ union in a press release. “It’s time to reconsider that group and give status to those who really need it.”
Young people are in the danger zone
The Medical Association mainly focuses on retirees. They are automatically granted status on the basis of a low pension, without regard to their assets, says BVAS. “At the national level, the largest number of people receiving the increased allowance are already in the elderly category,” says Clara Vanmuysen, press officer at the CM Health Fund. “But in Brussels we see that at least 40.8 percent of people aged 0 to 24 are entitled to an increased allowance in 2022. Twenty years ago, in 2002, the proportion was still 15.9 percent. (Continue reading below the chart)
Concretely, in 2022, 142,692 young people (0-24 years) will be entitled to an additional allowance in Brussels, compared to 56,504 people over 65 years of age. The city council has observed a similar development in other major cities, such as Antwerp and Liège.
The fact that assets are not taken into account, as the Medical Association says, is not true, says Vanmosen. “The income test that should determine whether a household is entitled to the increased premium takes into account cadastral income, but also payments from retirement savings or group insurance.”
Single-parent families and the platform economy
Although pensioners still have the upper hand, the group of young people who are eligible for this increased bonus is becoming increasingly larger. “We see that young people are increasingly ending up in the danger zone,” says Vanmuesen. “Many single-parent families and low wages have something to do with this, but we are also seeing the impact of the platform economy. Companies like Uber and Deliveroo are creating jobs with low wages and little social protection, and we are now seeing the impact.” In addition, unemployment rates and living wages among young people in Brussels are increasing. “Everyone who receives a living wage for three months is automatically entitled to an increased bonus.”
Another part of the explanation can be found in the large number of single-parent and one-person families in Brussels. “The more people find themselves alone with one wage, the more people need financial compensation,” says Vanmosen. “And if this wage disappears – for example due to illness – the financial situation deteriorates quickly.” This group again includes many young people, who “financial capacity is often less. Large families also have a greater chance of receiving increased benefits.”
Finally, there is a larger social problem, according to the press representative. “Half a million Belgians are sick for a long period of time today. In young people, this often relates to psychological complaints such as eating disorders. This also clearly has an impact on our social system.
To be clear, a higher premium does not mean that you will receive an amount each month, but it does mean that the government will contribute to health care costs. Therefore, low-income people have to pay less for health care. “For example, for a doctor’s visit, you pay four euros out of your own pocket without increasing the reimbursement. With the increased reimbursement, this becomes only one euro,” says Vanmosen. “We want to avoid the financial threshold for health care being too high so people postpone care.”
In addition to financial benefits, increased compensation also provides other benefits, such as a cheaper STIB subscription.
Ban honorary supplements
The fact that so many young people are in a vulnerable position is worrying, CM says. To ensure people don’t put off their care, there will also be a ban next year on charge supplements for people with increased allowances for outpatient care, or all care for which you don’t have to be hospitalised.
“There are very few dentists and orthodontists who are imitated, or charge bargain prices,” says VanMosen. “The supplements they order must be paid entirely out of their own pocket. This ban is good for low-income people, but it also has a detrimental effect. We have already received signals from our member advocacy department that dentists and orthodontists are turning away people who get On increased compensation. They are no longer welcome and we are very worried about that, because it is very difficult to find a dentist or orthodontist anyway.
