Belgium is made up of three sub-national regions (the Flemish, Walloon and the Brussels region) and three communities comprising the Flemish, French and the German community, with the French and Flemish communities sharing responsibility for Brussels, and each individual area having a government and council (the legislative body), which is responsible for certain aspects in health, education, cultural affairs and social support policies. Belgium is further subdivided into ten provinces and 589 local authorities, each province having a capital town where the provincial authorities are located.
Over the years many changes have occurred in Belgium’s health system. In 1936 existing departments within the Justice Ministry and Home Ministry were merged to form the Ministry of Public Health then a reform in 1980 deemed that many elements of health care should be the responsibility of each of the communities so the National Ministry of Public Health was created. In 1995 this ministry was expanded again to merge with the Ministry of Social Provision into the Ministry or Social Affairs, Public Health and Environment, incorporating two ministers in separate cabinets. In 2001 Social Provision and Public Health went its own way again, and the Ministry of Public Health, Food Chain Safety and the Environment became its present form.
Since 1945, Belgium has had a health care system based on compulsory health insurance, an integral part of the Belgian social security system. This involves independent medical practice, free choice of health care provider by the patient and a fee-for-service payment of providers, with reimbursement. About sixty per cent of the hospitals in Belgium are non-profit private institutions, while the rest are public, and the mutuality's are private legally independent, non-profit organizations.
Since there is no referral system in Belgium, specialists often form the first point of contact with the patient in the health care system and patients don’t normally have to wait long for access either to general practitioners or specialists.
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