Supplementary physicians' fees: a sustainable system?
Piet Calcoen1, Wynand P M M van de Ven1
1Department of Health Policy and Management,Erasmus University Rotterdam,The Netherlands.
Health Economics, Policy, and Law
|January 26, 2018
Summary
Supplementary physician fees in Belgium and France are unsustainable due to financial concerns and lack of clear patient value. Despite rising costs, evidence does not support better quality of care for these extra payments.
Area of Science:
- Health Economics
- Healthcare Policy
Background:
- Physicians in Belgium and France can charge supplementary fees beyond basic health insurance.
- These supplementary fees are increasingly unsustainable, with expenditure rising faster than total health costs.
Purpose of the Study:
- To analyze the financial sustainability and patient value of supplementary physician fees in Belgium and France.
- To evaluate the impact of supplementary fees on healthcare access and perceived quality of care.
Main Methods:
- Analysis of expenditure trends for supplementary fees versus total health expenditure.
- Review of factors influencing patient willingness to pay supplementary fees, including perceived quality of care.
Main Results:
- Supplementary fees constitute a significant portion of income for some physicians (up to one-third).
- The added value for patients is unclear, though fees may influence comfort and access.
- No evidence currently links supplementary fees to objectively better quality of care.
Conclusions:
- The current system of supplementary physician fees is financially unsustainable.
- Linking fees to quality of care raises social acceptability concerns.
- Policy measures to curb the trend in supplementary fees have been unsuccessful.
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