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8/27/20

The Netherlands: How the Netherlands got universal health insurance with a private market - "but polls show citizens still find healthcare too costly for the average citizen"

Critics argue that the Netherlands made a mistake in handing over so much of its health care to the private market. Dutch patients face higher financial barriers to care than their peers in more socialized systems, like Germany, Britain, Spain, and spending has accelerated in recent years, trends the critics blame on the privatized market.

The average cost to a Dutch citizen for health insurance is about 1,400 euros, or $1,615, annually. People with lower incomes get additional government assistance to reduce their payments. The government also collects contributions from employers to help fund the insurance scheme and covers the cost for children; revenues are spread among the insurers based on the health status of their customers. Public financing covers about 75 percent of the system’s costs; the insurers have also generally operated as nonprofits.

The benefits are designed to encourage cost-efficient use of medical care by patients. Dutch patients can visit a primary care doctor for free. For a visit to the hospital, they will need to pay toward their deductible. The annual deductible is today capped at €385 ($429), although people can choose to pay a lower monthly premium in exchange for a higher deductible — up to €885 ($980).

That is still well below the typical deductible in America (more than $1,600 on average for workers on their employer’s plan, and many people have a higher deductible than that).

The system has more or less delivered universal coverage. More than 99 percent of Dutch people have insurance; people with conscientious objections are exempted from the mandate to buy insurance.

The system is designed to funnel people with minor problems to a general practitioner to free up the ER for more emergencies. But Dutch patients weren’t thrilled with the idea of the co-ops when they first started nearly 20 years ago, wary about seeing somebody other than their normal physician. 

 Read more at: How the Netherlands got universal health insurance with a private market - Vox

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