According to reports in the Belgian media of a survey of attitudes towards health care, 40% of Belgians (more amongst Dutch-speakers than French-speakers) believe that the social security expenses need to be kept in check "by no longer administering costly treatments that prolong the lives of over-85s".
The obvious consequence of this, notes Le Soir newspaper, would be a two-tier health system. Poorer patients would have to make do with government medicine; wealthier patients would be able to cover the cost of operations and medicines. Le Soir says that in the Netherlands, pacemakers are no longer provided for people over 75.
By comparison, only 17% are in favour of withholding subsidies for illnesses that are the consequence of personal behaviour such as smoking or obesity.
Clearly ageism is at work. According to the survey, 69% of Belgians consider it legitimate to spend 50,000 euros for a life-saving treatment, but only 28% agree if a patient is over 85 years old. Dutch speakers are much more likely to exclude people over 85 from more expensive care. "These percentages in favour of exclusion are shocking," notes Professor Mark Elchardus, who led the investigation for Inami, the Institut national d'assurance maladie-invalidité.
Michael Cook is editor of BioEdge
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