Financing and costs of the Dutch health care system

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The costs of the Dutch health care system are rising, and simultaneously there is a pressure on controlling the costs. Presently the costs are controlled by the central government and are divided in two main categories:
- 65% of the budget is fixed (controlled): for this part insurance companies buy health care for a fixed price (variable and negotiatable quality and volume)
- 35% of the budget is on the free market: for this part the insurance companies can also negotiate over the price.
The government wants to enlarge the part that is free market. Besides costs, the other priorities of the government are quality, transparency, safety, innovation and prevention.

Enablers (the enablers are driving the costs up):

- Aging population
- Larger role of insurance companies, which might drive costs up
- More chronical diseases and “luxury” diseases
- Mergers between hospitals
- Consolidation in the pharmaceutical industry

Inhibitors (the inhibitors are driving the costs down)

- Outsourcing of health care services to low-cost countries
- Globalization
- Advanced medical technology
- New materials used in health care
- More health care that is uninsured


The view on health care is changing. There is an increased demand for good quality care, while the costs are rising. The government attempt to cut the costs, by reducing the insurance package and enlarging the premium paid by citizens.


Ministry for health care Hospitals Health insurance companies and experts


In 2006 there was a reform of the Dutch health insurance market. While before there was a dual system (based on income), the current system provides a basic insurance for everyone (costing approx. 1000-1200 euro per person) and an extended insurance, which is optional.

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