Publicatie datum

The impact of the crisis on the health system and health in the Netherlands.

Batenburg, R., Kroneman, M., Sagan, A. The impact of the crisis on the health system and health in the Netherlands. In: A. Maresso et al. (Eds.) Economic crisis, health systems and health in Europe. Country experiences. Copenhagen: WHO Regional Office for Europe, 2015 p. 247-282.
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At the onset of the crisis, the Dutch health care system was still in the process of transition following a major reform in 2006 that had as its main aims an increase in efficiency and a reduction in costs. Consequently, it is often unclear whether changes that happened after 2008 were the result of the crisis or the result of adjustments to enhance the operation of the new system. Moreover, health care was one of the last sectors in the Netherlands to be affected by budget cuts. Nevertheless, the worsening economic situation acted as a motivation for policy-makers, stakeholders and the public to discuss essential questions such as the affordability of health care, the generosity of the benefits package and the extent of user charges or compulsory deductibles within the health insurance system.

With the aim of controlling costs, a number of agreements were negotiated between the government and stakeholders, the most important of which was the 2013 Health Agreement with providers and health insurers. Mainly, measures targeted a reduction in input costs, such as limiting the income of medical specialists or encouraging GPs to prescribe cheaper drugs. Much more complex structural measures, such as the reform of long-term care, are only just beginning to be tackled and the outcomes remain to be seen. Within this context, accessibility, quality and affordability of care remain key concerns.