Proposition 54K0413

Proposition de résolution visant une meilleure prise en charge de l'orthodontie.

General information ¶

Authors

MR Daniel Bacquelaine, Luc Gustin, Benoît Piedboeuf, Damien Thiéry

Submission date

Oct. 7, 2014

Official page

Visit

Status

Adopted

Requirement

Simple

Subjects

resolution of parliament dental medicine health insurance

Voting ¶

Voted to adopt

Groen CD&V Vooruit Ecolo LE PS | SP DéFI ∉ Open Vld N-VA MR PP VB

Contact form ¶

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Discussion ¶

March 16, 2017 | Plenary session (Chamber of representatives)

Full source

The rapporteur is Ms Fonck who refers to her written report.

As you know, my group had priority seven proposals on orthodontist care.

My excellent colleague Mr. Thiéry – who listens to me, I’m sure – had also drafted a text on the subject. He agreed to join us. What a great idea to see the opposition and the majority together. The majority took a little time. She was a little hesitant. She had to consult, not immediately finding the interest of the proposal. But eventually, after thought and wisdom, she agreed to work on a text.

That said, I unfortunately have the impression, in view of the members present in the plenary session and those who do not listen, that the subject is of little interest.

I listen to you.

Madame Onkelinx, I know you always listen to me.

However, the subject is extremely important in that it concerns thousands of families in our country. It should be noted that 40% of children generally aged ten to fourteen years receive orthodontic treatment in Belgium. The cost of each treatment - the amount is appealing - represents a sum ranging from 500 to 5,000 euros with, on average, a refund of 800 euros from the health insurance.

It should also be remembered that one in five Belgians postpones their health care, their pharmaceutical care, this mainly for cost reasons, dental care being the ones most often postponed to later. However, we know that such care is essential. Indeed, certain specific dental problems have significant, even vital, consequences for the health of patients. Advances are therefore essential to improve access to dental care. Because despite the interventions of healthcare insurance and the advances achieved in recent years, these care remains, in some cases, very high.

When it comes to costs, the reasons are multiple. Among them is the fact that a large number of dentists are not conventional. The supplements applied are therefore important in many cases, especially when it comes to orthodontic care. And also the fact that the patient must advance the full amounts before being refunded by his mutual is another obstacle, a brake as well.

Dear colleagues, this is done! We again submitted an amendment which, unfortunately, was rejected in the committee and which aims to establish the third paying for the medical benefits provided by the dentist and this, in priority for the beneficiaries of the increased intervention and young people up to eighteen years.

Dear colleagues, if you still have a surge of wisdom, I imagine that you may be able to vote on this amendment right now in the plenary session. This part that is borne by the patient, which he must pay, Mr. de Lamotte, waiting for reimbursement by the mutual, remains obviously an important brake. We will then see what you will do with our amendment.

The text is of great simplicity. It calls on the government to provide for better reimbursement of orthodontic care for children, adolescents but also adults, and differentiated reimbursement according to the severity of needs. The government is also asked to analyze the reasons for the rate of discontinuation of dentists and orthodontists. One request that we had formulated and which was taken back – thanks to the colleagues in the commission – was to force dentists and orthodontists to give a quote to patients, so that they know what to expect.

I would have liked to address the Minister of Health but, obviously, the subject does not interest her. It is represented by four members. You will report it to him. There was a compromise in the committee. Our concession in the text – Mr. Thiéry, you know it well – is the phrase added: “In the limits of the existing budgetary possibilities.” We are somewhat suspicious, you see, dear colleagues of the government.

We heard the minister say, "Never, we will never touch my healthcare budget."We saw the measures: 900 million euros! This is a third of the budget effort, Mr. Laaouej, on the back of the sick and patients!

I know it is controversial, but I remind you of all the measures that hit health care, especially medicines.

You will not need to tell us tomorrow that you would like to follow our recommendation but that you did not have the means to do so. We will therefore be extremely attentive, dear colleagues, to what will be put in place by the government in the coming weeks, when we have voted this resolution unanimously – and I thank you again.

Mr. Speaker, Mr. Ministers, Mr. Frédéric, dear colleagues, allow me first to thank absolutely all the colleagues in the Public Health Committee who have worked closely or far on this proposal for a resolution.

I would like to thank Mr. Specifically. Frédéric for the text that was presented by the PS and from which we were also inspired. You will have seen that a number of amendments that had been proposed by the PS and other parties have been studied. This allowed us to reach a consensus on taking over the orthodontics that we considered necessary.

I will not mention the numbers. In order to avoid repetitions, I refer to the state of the places drawn up by mr. by Frédéric.

I would just like to confirm that, so far, care was only for children up to fifteen years old. In exceptional cases, this care takes place for young adults up to twenty-two years of age. We know that certain dental problems in young people may require a number of care or interventions well beyond the age of eighteen, or even twenty-two.

We also know that orthodontic treatments are subject to a specific reimbursement by insurance but also on this point, not everyone is on the same foot, including patients who would not have access to these insurance.

Treatment should also be considered for patients with a more severe pathology, such as palatine fissure, and other patients with medical conditions that may have concerns after the age of fifteen. This is one of the reasons why we wanted to implement this resolution, taking into account, of course, also the problem of pricing. I think mr. Frederick reminded him. A patient should be able to appear to his Orthodontist by asking him in advance for an estimate of the costs in relation to the intervention to be performed. I think we are on the same wavelength on this subject.

It is true that a resolution is a commitment, but it has no force of law. Some may say that we may not go far enough within the framework of this resolution but, once again, if we should wait for the perfection of a resolution or a bill, by definition, we know very well that they would never succeed. I have never seen a perfect resolution or bill.

It is also clear that a number of stakeholders will have to take a position. I think, among other things, of the Dentomut actors who will have to take a position in the context of the budgetary problem. This is why we believe that, among other things, for everything related to the nomenclature, it was not up to us, within the framework of this resolution, to take a position. There will still have to be a consultation. We hope that this will always be in the best interests of patients.

It is also important to take into account the fact that children over fifteen years old, but also adults who have a need for medical or dental treatment, are followed. Orthodontic treatments for children with palatine fissure also deserve special attention.

Mr. Speaker, dear colleagues, these are the points I wanted to highlight, being convinced that concrete initiatives need to take place in the field. I would like to conclude by pointing out that there was an amendment proposed by the PS in the framework – Mr. Frédéric recalled – of the third paying. We discussed this in the committee. It is true that we have not reached an agreement. We started from the principle that the problem of the third-party payer was much more comprehensive than the specific case, here, of orthodontics. That is why we did not follow this amendment.

For the rest, I would like to recall that many other amendments have been taken into account and have enabled, in committees, to reach a unanimous vote on this draft resolution.