RRI Tools

Reimbursements in health care: An agenda for change - Final report 2012-2015; King Baudouin Foundation, 2015; Authors: Peter Raeymaekers, Phillippe Vandenbroeck, Alain Denis, Josse Van Steenberge; Coordination: Gerrit Rauws, Tinne Vandensande, Karel Van Den Bossche,

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This publication presents a synthesis of the input from citizens, experts and policymakers, recorded in very diverse contexts: surveys, workshops and deliberations. The agenda focuses on the desired changes in the roles and tasks of stakeholders in decision-making processes and in the criteria for reimbursement. Above all, the process has demonstrated that well-informed citizens can make balanced and ground-breaking judgements in a short time, even on complex cases and issues.

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Citizens have different priorities in health care from those who currently make decisions in that area. First of all, citizens see quality of life as more important than extending the length of life, and they also factor in the quality of life of other people who are close to the individual. 

What is more, citizens insist on a health-based policy rather than the sickness-based policy which is still operating at present. What they want is not just a little attention to be paid to prevention, health promotion in all areas of policy and health education, but a much more emphatic focus on these areas.

The message is absolutely clear: make the best possible use of the available public resources for health care to promote quality of life and health, maintain the principle of solidarity and guarantee that everyone has access to health care.

These strong recommendations from citizens are a core part of the research and development
programme ‘Improving the use of resources in health care – the role of ethics and society’ which was carried out by the King Baudouin Foundation from December 2012 to December 2015.

This programme was organised in collaboration with the National Institute for Health and Disability Insurance (RIZIV-INAMI) and the Belgian Health Care Knowledge Centre (KCE). A committee chaired by Prof. Emeritus of Social Security Law Josse Van Steenberge provided support throughout the process. 

It was structured in three phases: an exploratory phase involving a European expert workshop in collaboration with the Belgian Advisory Committee for Bioethics and a series of methodological workshops; a laboratory phase incorporating the CitizenLab; and a consolidation phase in which the results of the CitizenLab were communicated and discussed with experts, stakeholders and policymakers.

This report concludes the KBF’s multi-year programme on reimbursements in health care. The key conclusions are summarised in the report. Extensive reporting on each individual phase has been provided in earlier papers and reports