Health in The Netherlands

Health In The Netherlands

Healthcare in the Netherlands can be divided in several ways: three echelons, in somatic and mental health care and in 'cure' (short term) and 'care' (long term). Home doctors (huisartsen, comparable to General Practitioners) form the largest part of the first echelon. Being referenced by a member of the first echelon is mandatory for access to the second and third echelon. The health care system is in comparison to other Western countries quite effective but not the most cost-effective.

Healthcare in the Netherlands is financed by a dual system that came into effect in January 2006. Long-term treatments, especially those that involve semi-permanent hospitalization, and also disability costs such as wheelchairs, are covered by a state-controlled mandatory insurance. This is laid down in the Algemene Wet Bijzondere Ziektekosten ("General Law on Exceptional Healthcare Costs") which first came into effect in 1968. In 2009 this insurance covered 27% of all health care expenses. The Netherlands was ranked first in a study comparing the health care systems of the United States, Australia, Canada, Germany and New Zealand.

For all regular (short-term) medical treatment, there is a system of obligatory health insurance, with private health insurance companies. These insurance companies are obliged to provide a package with a defined set of insured treatments. This insurance covers 41% of all health care expenses.

Other sources of health care payment are taxes (14%), out of pocket payments (9%), additional optional health insurance packages (4%) and a range of other sources (4%). Affordability is guaranteed through a system of income-related allowances and individual and employer-paid income-related premiums.

A key feature of the Dutch system is that premiums may not be related to health status or age. Risk variances between private health insurance companies due to the different risks presented by individual policy holders are compensated through risk equalization and a common risk pool. Funding for all short-term health care is 50% from employers, 45% from the insured person and 5% by the government. Children under 18 are covered for free. Those on low incomes receive compensation to help them pay their insurance. Premiums paid by the insured are about 100 € per month (about US$127 in Aug. 2010 and in 2012 €150 or US$196,) with variation of about 5% between the various competing insurers, and deductible a year €220 US$288.

From 1941 to 2006, there were separate public and private systems of short-term health insurance. The public insurance system was implemented by non-profit health funds, and financed by premiums taken directly out of the wages (together with income taxes). Everyone earning less than a certain threshold qualified for the public insurance system. However, anyone with income over that threshold was obliged to have private insurance instead.