Healthcare in Belgium is composed of three parts. Firstly there is a primarily publicly funded healthcare and social security service run by the federal government, which organises and regulates healthcare; independent private/public practitioners, university/semi-private hospitals and care institutions. There are a few (commercially run for-profit) private hospitals. Secondly is the insurance coverage provided for patients. Finally, industry coverage; which covers the production and distribution of healthcare products for research and development. The primary aspect of this research is done in universities and hospitals.
Organization
Healthcare in Belgium is mainly the responsibility of the federal minister and the "FOD Volksgezondheid en Sociale Zekerheid / SPF Santé Publique et Securité Sociale" ("Public Administration for Public Health and Social Security"). The responsibility is exercised by the governments of the Flemish, Walloon regions and the German-speaking community. Both the Belgian federal government and the Regional governments have ministers for public health and a supportive administrative civil service.
Political and regulatory
Care
Generally speaking, health care is organised in three layers: First line: the primary care function that is provided by physicians (GPs), emergency services and emergency rooms in hospitals. Polyclinics provide nonurgent first-line care (such as diagnosis and following up patients). Second line: acute and immediate care provided by hospitals for patients requiring technical interventions (surgery, technical diagnostics etc.) and acute curative care. Chronic or long-term care: is provided by rehab-clinics, service-flat care providers, old-age homes and home-care services.
Physicians
For common conditions like the cold, the flu, injuries and pain, patients contact their GPs.
Physicians in private practice are generally self-employed. Officially, they are categorized in the following framework: Private practice: General practitioners (family doctors) usually operate from their private practice although some group practices are emerging. The doctors are also syndicated in local chapters, which organise out-of-hours services during weekend and holidays and for the evening hours and during vacations. Patients can call a duty GP 24/7 who has access to their medical records. Specialists: many combine their private practice with a hospital posting, a teaching position or a similar research posting. Only a few operate private clinics (mostly ophthalmologists or dentists). Experts and assessment consultants: such specialists do not see general patients but evaluate patients either as a second opinion at the request of the patient or are appointed to assess patients and treatments for insurance purposes or by appointment by a court. Clinical practice: Specialists: many clinical specialists have a teaching position in hospitals (teaching staff, assistants or trainees and nurses on the job) or combine their hospital position with a teaching position at a university. Research clinicians: run clinical trials and do research. Most doctors working in hospitals also have a private practice. Exceptions include neurosurgeons or radiologists because they cannot invest in the high-tech equipment that is required. Doctors are usually paid on a fee for service by the patient at their private practice or by the hospital. Some specialists are employees on a hospital payroll or for research labs or universities. Assessment consultants are paid a fixed fee for their assessment report by whoever hired them.