People in Amsterdam are using healthcare services less because of higher insurance costs, according to Het Parool.

Since the increase of the compulsory excess (verplicht eigen risico) to 360 euros for Dutch health insurance in 2014, doctors have noticed an increase in the number of patients avoiding prescribed follow-up actions such as laboratory research, medication or a visit to a specialist.

When it was introduced in 2008, the compulsory excess was 150 euros. Het Parool states that the excess for Dutch healthcare may even increase to 400 euros in 2015.

Doctor’s orders

Especially in poorer areas, people are reluctant to follow up on a doctor’s advice due to the financial implications. According to a general practitioner in Amsterdam North, some patients are not even insured any more.

Health Minister begs to differ

The observations, gathered via an inspection of Amsterdam’s doctors and pharmacists, are in contrast to the findings of the Minister of Health, Edith Schippers, who recently stated that the increased excess had not led to a drop in people seeking healthcare.

Minister Schippers wrote a response to questions in parliament following the annual poll of members of the National Association of General Practitioners (Landelijke Huisartsen Vereniging). The poll found 94 per cent of surveyed doctors had witnessed patients choosing not to follow their advice due to financial reasons.

Chemists fail to explain medication

Another sign of financial strain from the changing health system is the failure of pharmacists (apothekers) to explain medication to patients, despite charging for it.

NOS reports that many pharmacies are not abiding by their own rules that require a pharmacist dispensing a prescription to a first-time patient to explain about the medicine, including effects and side effects.

New pharmacy charges

This requirement was introduced at the start of this year, when prescription explanation costs were moved to the compulsory excess, meaning patients will be billed for pharmacists’ advice, if it is needed.

Previously chemists included the cost of their time and explanation in the price of the medicine. Now it is listed separately and costs six euros on average.

The pharmacist’s organisation KNMP is highly troubled by the findings and attributes part of the problem to the high workload, with pharmacies required to do more, with fewer staff. Additionally, according to KNMP, patients' trust is under strain because patients hold the pharmacists responsible for the unclear price calculations.