Healthcare in the Netherlands Fundamental changes

C.J. (Kees) in ’t Veld, GPNetherlands College of GPs

c.intveld@nhg-nl.org

Healthcare in the Netherlands Fundamental changes

• How the system used to be• From January 1st 2006 onwards• Observations: chances, threats• Looking back on the process

Healthcare in the Netherlands Fundamental changes

Area 33.883 km²Population 16 millionLife expectancy 78 yrs

Healthcare in the Netherlands Fundamental changes

GPs: 8000 2580Patients 2350Fixed listGoalkeeper

Healthcare in the Netherlands Fundamental changes

Sickfunds (60% population) • Fee per capita • Orientation specific region

Private health care insurance companies (40%) • Fee for service• Nationwide

Healthcare in the Netherlands Fundamental changes

Health Insurance System January 1st 2006

Socialised, private system

Fixed packageLow-income: tax grantHigh-income: additional premium

Healthcare in the Netherlands Fundamental changes

Health Insurance System January 1st 2006

Three levels of additional packages

Healthcare in the Netherlands Fundamental changes

PatientsGovernmentHealth insurersProfessionals

Healthcare in the Netherlands Fundamental changes

Patients• 30% changed • Mixed emotions• Trust, hope, scepsis

Healthcare in the Netherlands Fundamental changes

PatientsGovernmentHealth insurersProfessionals

Healthcare in the Netherlands Fundamental changes

Government• The job has been done• Patients have choices• Quality, transparency

Healthcare in the Netherlands Fundamental changes

PatientsGovernmentHealth insurersProfessionals

Healthcare in the Netherlands Fundamental changes

Health insurers• Administrative difficulties• Cost containment?• Value for money?

Healthcare in the Netherlands Fundamental changes

PatientsGovernmentHealth insurersProfessionals

Healthcare in the Netherlands Fundamental changes

Professionals• Chances• Uncertain, insecure, threatened

Healthcare in the Netherlands Fundamental changes