2. General Perspective
“Everyone has a right to essential medical care, even if
their condition is caused by an unhealthy or reckless
lifestyle.”
“The health insurance system in the Netherlands is
based on the principle of social solidarity. Together, we
all pay the overall cost of health care.”
3. Overview
● Standard health insurance: obligatory for those living/working in Netherlands.
● Covers costs for: consulting a GP, hospital treatment, prescription meds.
● https://www.government.nl/topics/health-insurance/contents/cover-provided-by-the-standard-health-insurance-package
● All insurers offer the same standard package.
● Obligation to supply insurance to anyone applying for the standard package.
● The same premium is applied to all policyholders regardless of age/health:
○ Fixed, nominal premium and income related contribution (7.75% taxable income).
○ Mandatory excess payment of €375 (deductible).
○ Children under 18 are free of charge.
○ Low income individuals are eligible for health care benefit, based on income/living condition.
● If uninsured, the Healthcare Institute will withhold premiums from paycheck.
● Overall funding:
○ 50% payroll taxes, 45% insured premiums & 5% government.
4. Additional Insurance
● Additional insurance covers that which is not included in the standard
package.
● Examples: physiotherapy, contraceptives, dental care.
● Not obligatory.
● One can chose a different insurer than standard insurance.
● Insurance companies do not have to accept everyone who applies.
○ Can do health checks before accepting an applicant.
● 85% of population purchases a combination of both complementary and
supplementary voluntary insurance.
5. Health Care System: Pre/Post 2006 Reform
Pre-2006
● Composed of 4 parts:
○ Social Insurance for Long-Term
Care (AWBZ).
○ Supplementary private
insurance.
○ Social health Insurance (ZFW).
○ Alternative Private Health
Insurance (PHI).
Post-2006
● Composed of 3 Parts:
○ Supplementary Private Health
Insurance.
○ Universal “private” social health
insurance scheme (ZVW).
○ Social Insurance for Long-Term
Care (WLZ).
6. A Distinct Coverage Framework
● Under the Health Insurance Act (Zorgverzekeringswet), statutory coverage is
provided by private insurers and regulated under public law.
● Since 2006, every resident has to purchase statutory health insurance from
private insurers.
● Executed by private firms, with social regulations.
● Effects of the reform:
○ Increased consumer choice.
○ Mandate results in full coverage for the whole population.
○ Information transparency.
○ Increased health care spending.
○ Number of payment defaults has been increasing for years:
■ 325,000 defaulted payments in 2014.
7. Key Market Statistics
● Percent of population with health insurance (2014): 99.8%.
● Estimated population without health insurance (2014): 30,000.
● Percent of population in premium default (2014): 2%.
● Per capita health care expenditure (2013): €5,095.
● Average premium paid: €1,200 (fixed premium).
● Average Life Expectancy (2014):
○ Male: 79.9
○ Female: 83.3
● Market Segmentation:
○ 4 of the largest insurers account for 95% of all enrollees.
8. References
1. GREß, Stefan, Maral Manouguian, and JÜRGEN Wasem. "Health Insurance Reforms in the Netherlands." CESifo DICE Report
(n.d.): n. pag. 2007. Web. <http://www.stefan-gress.eu/mediapool/40/403223/data/dicereport107-rm1.pdf>.
2. “Health Insurance.” Health Insurance. Government of the Netherlands, n.d. Web. 13 Dec. 2015.
3. Maarse, Hans. Dutch Health Care Reform at the Crossroads (n.d.): n.pag. University of Maastricht. Web.
4. Maarse, Hans. "Private Health Insurance." Encyclopedia of Public Health (2008): 1157. Private Health Insurance in the
Netherlands. University of Maastricht, Mar. 2009. Web. <http://www.cef-see.
org/health/report_Private_Health_Insurance_in_the_Netherlands.pdf>.
5. Mosca, Ilaria. "Health Reforms in the Netherlands Have Increased Access to Health Care, but Have Also Led to an Unexpected
Growth in Health Spending." The London School of Economics and Political Science, n.d. Web. <http://blogs.lse.ac.
uk/europpblog/2013/01/30/health-reforms-netherlands-ilaria-mosca/>.
6. Mossialos, Elias, Martin Wenzi, Robin Osborn, and Chloe Anderson. 2014 International Profiles of Health Care Systems. Rep.
The Commonwealth Fund, Jan. 2015. Web. <http://www.commonwealthfund.org/~/media/files/publications/fund-
report/2015/jan/1802_mossialos_intl_profiles_2014_v7.pdf>
7. Schippers, Edith. "TOWARDS A SOUND SYSTEM OF MEDICAL INSURANCE? Consumer Driven Healthcare Reform in the
Netherlands: The Relaxation of Supplyside Restrictions and Greater Role of Market Forces. (2002)." TOWARDS A SOUND
SYSTEM OF MEDICAL INSURANCE? (n.d.): n. pag. UK Health Policy Consensus Group, 13 Sept. 2001. Web.
