Proposed reforms of the healthcare system in the Netherlands beginning in 2015 may result in an almost 20 per cent increase in healthcare insurance premiums, according to calculations by trade labour unions and employer groups.

That adds up to about 200 euros extra per year, or an average insurance premium of 1.321 euros per month. Insurance industry lobby group ZN calculates things a little differently, estimating a smaller increase of 100 euros per year.

Nevertheless, the Dutch government is showing concern that costs for health insurance in the Netherlands will indeed rise if the changes to long-term healthcare go through parliament.

Changes to long-term healthcare

The proposed changes involve the reform of long-term care. Currently, municipalities fund home care, health insurance companies are responsible for short-term care and the government pays for long-term care, covered by the Exceptional Medical Expenses Act (Awbz).

The act covers everything from transportation for the disabled to psychiatric facilities. These costs are growing: from 19 billion euros in 2002 to 29 billion euros in 2014 and a projected 33 billion euros in 2017.

The government hope to save five billion euros over the coming years on the expected growth of healthcare costs, and to keep future long-term care costs at 2014 levels.

They plan to do this by significantly cutting back Awbz costs and shifting some responsibilities of the act to municipalities or the general health insurance system. This includes, for example, making funding for all mental health institutions and home care the responsibility of insurers.

Increasing insurance costs

The unions and employer groups estimate that these changes will result in employers having to pay 1,6 billion euros more in additional health insurance premiums. Excesses on policies would also go up to 400 euros for an adult.

"These increases in employers' costs are an obstacle for entrepreneurs who want to employ (more) personnel," they warned in a letter to the government.

In response to their concerns, the Department of Health announced that the "consequences and solutions of the plan are being examined."

One possibility is that the government could compensate the rise through taxes, but that will take money from elsewhere in the budget.

Low uptake of cheap insurance policies

In relation to health insurance policies in 2014, far fewer people than expected opted for the new cheaper health insurance policies that restricted where patients could be treated with full coverage.

This year is the first time insurers offered the so-called selection policies, which are between five and 15 euros a month cheaper than a standard policy.

This is because holders wanting full coverage of costs can only go to institutions with which insurers have a contact, leading to suggestions that cheaper insurance carries greater risks.

Insurers admit they expected more interest. A spokesperson for VGZ/Univé insurers attributed this in part to "urban myths," such as that a patient from Limburg would have to go to Groningen to be treated, or that someone who broke a leg could not go to the nearest emergency centre.

"Both nonsense," the spokesperson said. "We have at least one hospital available in every province and it is possible to receive emergency care anywhere."

If the government goes ahead with its proposed changes, however, these low numbers might see a sharp increase next year.


Source: Volkskrant, Trouw