The subject is delicate. We obviously have to support those who are sick. Everyone will agree, I think. But the figures force us to wonder about the “category” of the long-term sick, as the statistics call it. Above all, note the rate at which this category is growing. Thirty years ago, 2.5% of Belgians had the status of long-term sick. Today, it is more than double. Half a million people have been unable to work for more than a year and are therefore officially considered to be “long-term sick”. Today, Belgium has one and a half times more long-term sick people than unemployed people.
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The subject is delicate. We obviously have to support those who are sick. Everyone will agree, I think. But the figures force us to wonder about the “category” of the long-term sick, as the statistics call it. Above all, note the rate at which this category is growing. Thirty years ago, 2.5% of Belgians had the status of long-term sick. Today, it is more than double. Half a million people have been unable to work for more than a year and are therefore officially considered to be “long-term sick”. Today, Belgium has one and a half times more long-term sick people than unemployed people. The causes have evolved. The first cause of long-term illnesses is no longer legendary back pain, but mental problems. Some 35% of long-term patients have this type of problem, such as depression or burnout. The reader might think that the latter concerns above all exhausted workers at the end of their careers. He would be wrong: the age group most affected by absenteeism due to burnout is young people aged 20 to 35. A quarter of young people with long-term illness are due to burnout. Of course, all of this has a cost. A long-term patient costs money, first and foremost to the state. After the Scandinavian countries, Belgium is the European country that spends the most to financially help long-term patients. Some 3% of the gross domestic product is devoted to it. But the cost is just as gigantic for companies. In total, the cost of long-term illnesses is therefore rather estimated at 5.3% of the gross domestic product (figures from the OECD, 2022). By way of comparison: the average in the European Union is “only” 3.6% of GDP, ie 50% less. If Belgium fell back to the European average (a goal that could hardly be described as ambitious), this would represent a direct saving of nearly 10 billion euros. While the numbers are indisputable, a root cause analysis is much more complex. However, it is possible to make a few observations. First of all, there is a link with the general context. The pandemic, for example, has made people more anxious. Then, we observe a spectacular increase in long-term illnesses among the over 55s since the abolition of the early retirement scheme. The drop in the number of early pensioners following the early retirement reform actually coincides with an equivalent increase in the number of long-term patients in the over-55s bracket. If it is impossible to demonstrate a causal link, it is difficult to depart from this impression. In the absence of a pre-pension scheme, people over 55 who want to stop working can often obtain a medical certificate for mental disorders fairly easily. In addition, it will be noted that half of the people who today claim sickness benefits for mental disorders had previously been unemployed. Their unemployment benefit was thus transformed into sickness benefit. This analysis forces us to put the euphoria linked to the fall in unemployment into perspective. The authorities must tackle the problem of the long-term sick. The federal back-to-work plan will not be enough. A preventive medical policy, honest doctors, but also rigorous controls must be part of a targeted policy. And those who feign illness will have to be deprived of their benefits, both to ensure the financial sustainability of the system and out of respect for the genuinely ill.
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