Healthcare in the Netherlands

On 1 January 2006 has been introduced in the Netherlands with the health care reform in the Netherlands, a new health insurance system. The classic difference between the statutory and private health insurance is eliminated. All residents of the Netherlands are from 1 January obliged to with a health care provider - complete Health Insurance - legally defined.

Basics

Historically, the Dutch health insurance system for general medical care to 2005 was very fragmented. A considerable part of the population ( about 60 %) was statutorily insured. Others were privately insured, for certain risk groups had the opportunity to complete a statutory standard policy. For certain groups of officials were beyond special public health insurance schemes. Over the years, even three systems were developed for the insurance against the cost of curative medical treatments two, including specialist officers regulations, which differ substantially in terms of their foundations, their function and their financial consequences for the insured each other.

With the new health insurance law pursued health minister Hans Hoogervorst, the aim of replacing the existing fragmented system with a uniform legal insurance to all residents of the country. The Health Insurance Act ended the situation that people with comparable incomes significantly different from each pay contributions and that the insurance depends on the employment situation.

The law provides not only the creation of equal conditions for insurers and insured against, but also the strengthening of the roles of citizens, service providers and the insurer so that they behave as efficient as possible in the health system. Citizens can have both greater financial responsibility and more impact and real freedom to choose a health insurance policy. The insurer will come into greater competition with each other to get the best price -performance ratio for their policyholders to see providers. The providers must turn work merit-based, but also get more opportunities to offer exactly the services that citizens need and want.

The government wanted to create an insurance system, which strengthens the one hand, the ownership and the market function and on the other hand, social conditions such as the solidarity between different income and risk groups provides a solid foundation. In light of the reforms that have been carried out in healthcare in the last fifteen years - for example the introduction of competition in the health insurance system and the solidarity surcharge in the private health insurance - the new health insurance system is rather a logical step in the same direction as a fraction with the past.

Vertices of the Health Insurance Act

Compulsory insurance

All residents of the Netherlands must have health insurance. To this end, they enter into a contract with an insurance company. How the package looks is regulated by law.

Standard package with necessary services

The standard package of services under the new health insurance law includes necessary, curative services, which were tested for their effectiveness, cost efficiency and affordability collective way.

Implementation by national units insurer; Recording and liability

Is performed the insurance from private insurance companies, which fulfill the requirements set out in the Health Insurance Act. As non-life insurers, they are also bound by the laws for the non-life insurance industry. Profit intentions are allowed; the profit can optionally be distributed to the shareholders. The currently active private health insurers, as such continue to exist, and the existing health insurance can be transformed to private providers. Also for new providers, the market is open.

The efficiency of the new system is ensured by the fact that the insurance companies are constantly competing with each other. The insured may change the provider and the provider may no one who lives in their area of ​​activity, reject as insured annually. In what form the default package is offered, the insurer may in principle decide for themselves. Are possible both in kind and reimbursement of costs or a combination of both. The insured can freely choose one of these forms.

Lump-sum contribution

Almost half of the total premium load is carried in the form of a lump-sum contribution of the insured. Thus, the cost-consciousness is encouraged. The insurer can set the fixed contribution for each policy offered by them. In this case, however, an important rule is: For each type of policy a single premium level may apply. The age, state of health and the social conditions of the insured must not play any role. All who have the same policy, pay the same contributions. Of course differences between the individual insurers are possible. Thus, the competition between the insurance companies will be encouraged and sharpened the awareness of costs of the insured. For group insurance premium discounts may be offered. The flat-rate contributions were expected framed in 2006 to an average of € 1100 per year. In reality, the cover provided by insurance companies have been coming to an average of € 1050.

Insured up to 18 years stay free lump sum contribution. To finance the system for minors, the public contribution to the health insurance fund is paid.

Income -dependent contribution

In addition to the lump-sum contribution An income-related insurance contribution is provided in the Health Insurance Act. It is calculated as a percentage of income ( for employees in 2008: 7.2 % to € 30,000 ). Employers are obliged to provide their employees to reimburse the amounts paid by them income-related contribution. For the collection of these contributions and their deposit into a health insurance fund (or: ' Health Fund ') is responsible tax authority. The income-related contributions are - calculated over the entire population - cover about 50 percent of the total premium load.

Government contributions

The contributions to children and young people under the age of 18, as already stated, financed by state contributions to the health insurance fund.

Risk equalization

The revenues of the insurance companies consist of lump sums from their insured and the risk equalization payments they - from the health insurance funds - depending on the risk profile of their insured: get (or ' health fund '). Without a well-functioning risk equalization system a Kontrahierungspflicht would not be possible, because the insurers have not thereby no influence on who they take and from whom. For disproportionately many " bad risks " significant financial problems could then result. To prevent this and to create a " level playing field " for the insurer, a risk equalization system with clear and identical for all insurers criteria is essential.

Deductible

For all insured persons aged 18 years and since 2008 is considered a committed deductible of € 150 per year. In addition, the insurer may also offer a more extensive voluntary participation: it can vary from 100 to 500 Euros per year. The obligated deductible has replaced the contribution introduced in 2006 repayment. Under this system had insured over 18 years, the name few or no medical services claim in a calendar year, be entitled to a contribution refund. That was the case when the value of the insured benefits that have been taken in that calendar year to complete, a pre-established maximum amount does not exceed. The insured the difference between the value of the services received and this amount ( 2006: € 255) was then refunded.

Health grant

With the introduction of the Health Insurance Act a uniform contribution system is provided for all insured. Contributions include as I said from a income-related part which is collected by the tax authority, and a standard component which is payable directly to the insurer. To ensure that no one is overburdened financially by health insurance, a health subsidy is introduced. The amount of the grant depends on the income of the insured. Compensated so that the portion of the lump sums in excess of a set as a reasonable limit. If citizens really compare offers from different insurers will not put the insurance premiums actually paid used to calculate the height of the health subsidy, but the average amount of lump sums on the market. For the distribution of the grants a new, tax authority affiliated agency is responsible. The next citizen eligible for a grant must submit an application in which they estimate their own income and that of their partner for the coming year a year. On this basis, they receive every month ( by the state ) for a grant.