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Universal private health insurance in the Netherlands: the first year

van Ginneken E, Busse R, Gericke CA
Journal of Management & Marketing in Healthcare 2007, 1 (2): 139-153

[Translate to English:] Zusammenfassung


In 2006, a single mandatory private health insurance scheme with flat-rate contributions and tax compensation was established in the Netherlands. All health insurers now operate under private law, compete with other private insurers and are allowed to make profits and pay dividends to shareholders. The implementation of the scheme shows that an incremental approach to reform can bring about fundamental changes, and that while such a change is demanding on all stakeholders, it is manageable. The reform has had great influence on the relative positions and roles of health insurers, patients and healthcare providers, illustrated by the fact that around 20 per cent of citizens changed insurer within one year. The empowered insured are the clear winners, as they now have more choice and influence. Moving forward, it will be interesting to see whether a government looking to reduce its role in the healthcare system can truly safeguard the accessibility and quality of the system when the players increasingly start behaving as market-driven for-profit companies. In this regard, the question whether a health insurer can be the agent for patients and the insured, ie whether their interests are truly aligned, will be crucial to the long-term success of this reform.

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