Healthcare in Belgium is best depicted as a 3 legged table-like structure standing over the patient. The table-top is a primarily publicly funded healthcare and social security service, run by the federal government, which organizes and regulates the Healthcare. The first leg provides healthcare in the form of independant private practisioners and public, university and semi-private hospitals and care institutions, there are a few (commercially run for profit) private hospitals. The second leg is the insurance cover provided to patients and the third leg is formed by the industry which covers production (and distribution of healthcare products) and research & development, although an important part of the research effort is done in universities and university-labs and -hopsitals.
Healthcare in Belgium is mainly the responsibility for the federal minister and the so called "FOD Volksgezondheid en Sociale Zekerheid / SPF Santé Publique et Securité Sociale" (in english "the Public Administration for Public Health and Social Security") for some matters responsibility is delegated to the autorities of the Communities however in practise these responsibilities are exercised by the Flemish Regional gouvernment, French (Walloon) Regional gouvernement and by the German-speaking Community gouvernement. Both the Belgian federal government as the Regional governments have their proper ministers for public health and a supportive administrative civil service.
Public Administration for Public Health, Food Chain Safety and the environment  (FOD Volksgezondheid, Veiligheid van de Voedselketen en Leefmilieu / SPF Santé publique, Sécurité de la Chaîne alimentaire et Environnement)
Directorate Communicable and infectious diseases :
plays an important role within the Belgian, European and international networks of surveillance and respons to infectious diseases and food safety hazards.
early and rapid identification
microbiological monitoring of communicable and infectious agents,
preventing and treating such diseases.
Food borne pathogens
Mycology and aerobiology
Directorate Expertise, service provision and customer relations :
providing the logistical, technical and scientific support.
Biological standardisation : Assessment and checking of the quality of biological medicines for human use (vaccines and blood products) before market
Quality of medical laboratories : Assessment and checking of the quality of clinical biology laboratories and in vitro diagnostic medical devices
Biosafety and biotechnology & platform Molecular biology and biotechnology : Assessment of the risks linked to the use of genetically modified organisms (GMOs)
Directorate Food, medicines and consumer safety
analytical chemical research to promote public health : to detect the presence of chemical substances in food, consumer non-durables and the environment; scientific research in the following domains:
Chemical residues and contaminants
Directorate Public Health and surveillance epidemiology and toxicology centre
to provide reliable, practical and impartial information on the health of the Belgian population, inform the policy makers and population on factors that influence public health and public health policy.
risk factors that affect health and well-being
monitoring health problems illnesses that constitute a risk to public health
assess the impact of lifestyle on public health a
improve the quality of care
assess the risks of exposure to chemical substances and radiation
coordinating sharing an transmission of health information in Belgium
Belgian GLP Monitoring Programme
Quality Assurance Bureau (QAB) of IPH has been the official GLP (Good Laboratory Practice) Monitoring Authority for Belgium since 1988
Federal Agency for medicines and health products.
is the competent authority for medicines and health products in Belgium
Safety of the food chain
Federal Agency for the Safety of the Food Chain (FASFC).
is the competent authority for safety of the food chain in Belgium
the Provincial Council : which is the elected body
the Deputation or Provincial College and the Governor, who is appointed by the regional government, are the executive body, within that college one deputee has the responsibility for welfare and social affairs.
none competent at this level
The Provicial authority for wellfare is competent for matters that transcend the local level or local competences.
Assistance of people with disabilities and special needs
Assistance with chronic care
Assistance with psychological care
Assistance for palliative care
Care for the elderly
Care for children taken into public care by the juvenile judge
Hygienic controle of industrial kitchens
Monitoring and registering of genetic birth defects
The provincial authority is also competent for catastrophy planning and management of the emergency services,
Firefigthing services, including the Civil protection service
private subcontractors (towing services, salvage, lifting and transport services) in case of emergencies or catastrophies
Coordination of all emergency services (police, highway services, army) during catastrophies
City or Communal Council
College of Mayor and Aldermen ; dedicated alderman for Social affairs
in Dutch : Openbaar centrum voor maatschappelijk welzijn (OCMW),
in French Centre public d'action sociale (CPAS)
in German Öffentliches Sozialhilfezentrum (ÖSHZ).
In larger cities these public services manage large budgets, with a substantial administrative burden and run Hospitals, Clinics, Rehab-centers, Old-age pensioners residences and day care centres. The largest PCSW for example is the one in Antwerp it managed in 2013 a budget of 461 million Euros and paid benefits to people with no or very small incomes for a total of 125 million , the PCSW employs a workforce of over 1000 people, the Hospitals and other care institutions are grouped into a separate organisation called ZNA  (Care Network Antwerp) hat employs another 7000 people, and had a budget of around 568 million euros in 2010.
The government pays each mutual health association depending upon the number of registered members. Most of them are (historically) affiliated to a political institution, however there is no substantive difference between them as reimbursement rates are fixed by the Belgian government. Insurance funds do not cover 100 per cent of the patient's bills and typical reimbursement is between half to three-quarters of a typical doctor or specialist visit. Insured persons have a standardized credit card style SIS-cards which are needed in pharmacies and hospitals.
The first national law concerning the finance and provision of health care was enacted in 1894, with social insurance being introduced in 1945.
Social security is given to people who need compensation for "social burdens" (disease, children, ...) or to people who do not have income at all, due to unemployment or as pensions. Pensions make up the largest portion of the National Institute for Disease and Invalidity Assurance (RIZIV/INAMI), which is the public institution which makes the financial reimbursements, and which is the core spending of the Belgian state. During the negotiations for the sixth state reform, it was agreed upon to transfer the responsibility for child benefits to the communities.