Someone once told me “If the mafia is not outside the system, then it is inside the system”. My experience with the Belgian healthcare makes me think of the second option.
My girlfriend had to be operated of an infection and because of language issues and lack of knowledge of the Belgian system she decided to go for the private sector, choosing an English-speaking doctor recommended by a friend working in the European institutions.
The first checkings were quite expensive but considering the gravity of the situation we didn’t want to look at the prices and focus on getting the operation done. This private/independent doctor operated her in the Clinique Edith Cavell which is supposed to be among the best in Brussels.
The doctor was leaving the same day for holidays so we had to rush to operate or we risked having to wait one month –aren’t there other surgeons in the most expensive hospital in Brussels?-. Anyway, the day of the operation came and we went to this fantastic private hospital. We had to wait 2 hours more than scheduled, and when the operation finally took place my girlfriend was sent back half-unconscious to the room where I was waiting. The doctor didn’t show up to explain how it went so I had to ask a nurse to call her to get a briefing of the situation. The doctor doesn’t work for the hospital which means that it took more time to find her mobile number. We finally managed to talk to the doctor who was already on her way to the airport eager to start her holidays, luckily the operation went well. The only personnel I saw that day apart from the nurse was the anaesthetist who showed up 1h later…
We went home and she started the recovering of the surgery. Some days after the operation my girlfriend started bleeding. We called the bureau of the doctor who operated her but not a single doctor was left for urgencies; all the doctors were on holidays. We had no other choice than going to urgencies in the same expensive private Clinique of Edith Cavell, the waiting room was empty and yet they had us 1,5h waiting with her close to fainting due to the haemorrhage. Exercising extra pressure we managed to find a bed where she could lay down. Then a very nice nurse informs us that they have no urgency doctors available in the hospital but they are trying to find someone, hence the delay. 45 minutes later a kind doctor appears telling us from the start that he is a surgeon and not a generalist and hence he doesn’t know much about these kinds of operations but he will have a look anyway. Luckily the haemorrhage is nothing serious and it can be stopped. 2h later we go back home.
We start to find this scandalous.
The story continues when I have to go visit a doctor in the same hospital to check that I have not been contaminated by the infection of my girlfriend. My girlfriend’s doctor before leaving on holidays had asked her to have me seen by a doctor friend of hers who is also working as independent in the facilities of the Clinique Cavell. Full of suspicion I follow the instructions. I go see the doctor, the visit happens normally, except from the fact that he uses his own laptop and not the computer or the hospital facilities. The surprise comes when is time to pay: he asks me to pay cash the arbitrary amount of 50eur. I’ve been to other doctors so I know that this price is quite expensive; I ask why is 50eur and he tells me that independent doctors are free to charge us whatever extra to the regular amount for their honoraries. Weird. I don’t have 50eur in cash so I ask if I can pay by card to the secretary outside. No, he charges customers directly and he wants it cash so he asks me to go to withdraw money in the ING ATM machine which is in the ground floor of the Clinique. I find this very awkward. Before leaving he asks me to put the 50eur in an envelope and slide it under the door of his room later on because he will be with another visit.
Before leaving I ask for the voucher for the “mutualite” so that I can get some money reimbursed, he agrees but refuses to write down the amount of 50eur. It is not necessary, he says. Right, so he doesn’t want to declare the expenses; perfectly visible black market operations in the healthcare jetset…
Puzzled by the experience I leave the room to go withdraw money. The ING ATM inside the hospital doesn’t work so I end up having to go to another bank 5 minutes walk.
When 15 minutes later I slide the envelope under the door of the room of the “doctor” I ask myself how it can be that in a developed country such as Belgium:
– I can’t pay by bankcard in a hospital,
– I get charged random amounts that don’t appear in the receipt,
– Payment is done sliding an envelope with cash under the door?
All in all, how can it be that the Belgian tax authorities don’t stop this legal black market taking place in their semi-private hospitals?
In order to find out whether the system is weird or it is me that I’m special I go directly to my mutualite with the voucher from the doctor. When I explain them the situation they recognise it immediately: these are the famous rip-offs of private hospitals such as Edith Cavell or Park Leopold, they employ independent doctors who are free to charge whatever they feel like and are not accountable to the hospital, they make good money with EU civil servants and internationals. They work as a network so they send customers from one another for different kinds of checks. This way they work in parallel to the normal system.
They explain me that the price of the visits is regulated and the official price for my visit was 23.7eur (the basis on which I get reimbursed by the mutualite) and they charged me twice as much and it’s ok, they are free to do so. The Belgian system allows this. If I would be an EU civil servant and the mutualite of the European Commission (taxpayers money) would be paying the bill for me I could chose not to care but as an average person with a normal salary the issue really shocked me.
Perplexed and irritated I went home and think of moving to Siria…