The Dutch system combines market mechanisms with solidarity and continues to evolve.
The Netherlands has one of the best-performing healthcare systems in the world, based on solidarity and accessibility. The Netherlands has a regulated competitive healthcare system combining universal coverage with private insurers.
Key features:
- Universal coverage, children under 18 are incorporated in their parent’s insurance.
- Private insurers under public regulation
- Strong primary care
- Managed competition
The system is buit on three pillars:
Health Insurance Act (Zvw): Madatory basic insurance which covers GP visits, hospial care, medication. It is funded via premiums, income contributions executed by insurers
Long-term Care Act (Wlz): for people requiring intensive, long-term care, for example elderly and disabled persons. It comprehends insitutional and homecare and is publicly financed.
Social Support Act (Wmo): Municipal responsibility ; Support at home and participation ; Means-tested contributions
The insurance is covering general practitioners, hospital care and medications. It is funded via the premiums people pay and income contributions when they have a job. The financing comprehends: Citizen premiums, employer contributions, government subsidies and deductible (own risk) like dental care. The system encourages a responsible use of care.
The insurers are purchasing care, contracting providers and monitoring cost and quality. The GP is the first point of contact and a referal is required to visit a specialist, which ensures efficiency and cost control.
The government is running a website called : Reliable information on illness and health (https://www.thuisarts.nl/) in order for people to receive official and proper information before going to a doctor.
Laws and regulations
The Netherlands has about 2,500 rules and regulations for hospitals. All board members of an hospitals are responsible for the risk management of all those laws and regulations. About 48% of all those rules and regulations are medical guidelines developed by medical doctors, nurses and infection control institutes, etc. This ensures a high quality of care. The Ministry of Health is playing a part in the financial control.
The strenghs of the system
- High quality outcomes
- A strong primary care
- Good access compared to internationaly
The challenges are an ageing population, workforce shortages, rising expenditures, pressure on accessibility.
