Pax medica op de helling ?

Abstract

After the sharp confiicts between the government and the medical unions in 1964 on the occasion of the health insurance reform, which introduced the «agreement system» for medical fees and repayments, a form of bargaining economy has developed in Belgian health care, with sick funds and medical unions as the major parties. This «Pax Medica» seems to be threatened by a series of financially motivated government measures aimed at reducing the medical group's professional autonomy and dominance. This article discusses the historical context, the parties involved and the development of these confiicts, pointing out the striking analogy with those of 1964, particularly as far as the unions strategy is concerned. The present state of affairs suggests not a threatening of the «Pax Medica», but rather a stabilization of the established power relationship between government, sick funds and medical unions, which will respect and continue the rules of democratic compromise.