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At the occasion of its 50th anniversary, the National Institute for Health and Invalidity Insurance (NIHDI) asked the Federal Planning Bureau to draft a report on the social impact of public health care and health care insurance. We focused on three specific questions. First, what was the contribution of health care to population health during the past half-century? Lacking sufficient data on other dimensions of health, we look at mortality and life expectancy. Two approaches to this question lead to the same conclusion: the expansion of health care has contributed substantially to the increase in life years. The second question concerns the role of health care in the economy. The value added and employment in the branches Health care and Social services has increased vastly between 1970 and making health care an ever more important part of the Belgian economy . The third question is about the impact of health care and public health care insurance on inequalities in health and income. Among other findings, we report that in Belgium there is no social inequality in the use of general practitioner, though there is in specialist consultations. Also, a fairly large number of older persons have to cope with own contributions to health care that exceed 10% of their income.