The philosophy underpinning the Dutch health care system is based on several more or less universal principles: access to care for all, solidarity through medical insurance (which is compulsory for all and available to all) and high-quality health care services. Inevitably, the Dutch system has also been shaped by a number of historical trends and developments and social conditions.
Foundation of the health care system
The Dutch health care system is governed by 4 basic healthcare-related acts:
- the Health Insurance Act (Zorgverzekeringswet)
- the Long-Term Care Act (Wet langdurige zorg)
- the Social Support Act (Wet maatschappelijke ondersteuning)
- the Youth Act (Jeugdwet)
The 4 healthcare-related acts form the foundation of the Dutch healthcare system. The Health Insurance Act (which provides for hospital care) and the Long-Term Care Act (which focuses on other types of care) account for the bulk of the healthcare budget available in the Netherlands.
The Long-Term Care Act is a national act governing healthcare throughout the Netherlands. In implementing the Health Insurance Act, private health insurance companies play a key role in a system based on “regulated competition” and a number of specific public requirements.
The Social Support Act and the Youth Act provide for other forms of care and support. The roughly 400 municipalities in the Netherlands are primarily responsible for enforcing these 2 acts.
Principles of the Dutch healthcare system
The current Dutch healthcare system can best be explained by looking at a number of recent changes. In 2006 the new Health Insurance Act entered into force, under which all residents of the Netherlands are entitled to a comprehensive basic health insurance package. This act is implemented by private, competitive health insurers and healthcare providers. It should be noted that virtually all health insurance companies in the Netherlands are not-for-profit cooperatives that allocate any profits they make to the reserves they are required to maintain or return them in the form of lower premiums.
Long-term care, youth health services and social support
The Long-Term Care Act, the Social Support Act and the Youth Act were introduced more recently, having entered into force in their present form in 2015. The Long-Term Care Act is administered by special long-term care administrators at the behest of the central government. Additionally, several other organisations are involved in its implementation, such as the Centraal Indicatiestelling Zorg (Care Assessment Agency) and the Centraal AdministratieKantoor (Central administration Office). The local authorities are responsible for implementing the Social Support Act and the Youth Act – they provide the support, assistance or care services or are supported in this process by a healthcare provider.
The motivations behind these laws are opportunities to improve the quality of the care provided, promote an integrated approach, and keep healthcare available and affordable in times of an ageing population and in which many people suffer from chronic illnesses. The foundation of these domains are people’s opportunities rather than their shortcomings. Initially, people are encouraged to draw on their own network and resources for support, but support is always available for those unable to secure it themselves. Those requiring permanent supervision or 24-hour home care are entitled to care services under the Long-Term Care Act.
The text above is an abstract from a publication of the Ministry of Public Health, Welfare and Sport. Read the full text in the publication 'Healthcare in the Netherlands'.
National Health Care Institute
The National Health Care Institute (Zorginstituut Nederland) carries out tasks relating to two Dutch statutory health insurance schemes: the Health Insurance Act (Zorgverzekeringswet) and the Long-Term Care Act (Wet langdurige Zorg, Wlz). Read more on these tasks on the webpage 'Tasks of the National Health Care Institute'.
