Evaluation of Dutch Health Insurance and Market Regulation Acts

Three years after the change of the Health System in the Netherlands, NIVEL and Erasmus University Rotterdam evaluated the Health Insurance Act, Health Care Allowance Act and the Health Care Market Regulation Act.

In the Netherlands on 1 January 2006, the Health Insurance Act (Zvw) and the Health Care Allowance Act (Wzt) came into effect. By virtue of the Zvw, in principle everyone in the Netherlands is obliged to take out health insurance. The Wzt allows for households with a household income below a certain level to receive compensation for the insurance premium in the form of a health care allowance. On 1 October 2006 followed the Health Care Market Regulation Act (Wmg). According to the explanatory memorandum, the Act contributes to changes in the Dutch health care system, permitting more room for consumer choice and competition among health care providers and health insurers. The Wmg contains regulations designed to arrive at an effective system of appropriate health care, to control the growth of health care cost and to protect and promote the position of consumers

NIVEL, the Netherlands Institute for Health Services Research, and the Erasmus University Rotterdam evaluated all three Acts. The aim of this first evaluation was to obtain information about the way in which the laws were introduced and implemented in practice; about any bottlenecks or problems that have become manifest; and about the efficacy and (side-) effects of the legislation.

On the whole, the findings of the evaluation of the Zvw/Wzt and the Wmg may be summarised as ‘on balance positive’, despite the discovery of a number of serious bottlenecks and problems. The identified obstacles and the solutions proposed in the evaluations should be seen against the background of a relatively smooth introduction. The problems concerning the new instruments or existing instruments in the situation have been explicitly described as possible obstacles, for which nevertheless there are also empirical indicators that they do arise. This is because to date, in many case there is only limited experience with the application of this set of instruments.