Recently I haven’t been posting, in part due to ill health, but don’t worry because I am feeling good and optimistic about the future.
However, I have new implications to consider including healthcare in The Netherlands.
I had always assumed that the Dutch system was similar to that in the UK – free at the point of access to all. But the other day I read that it was a private health care system. Time to investigate!
Pre-2006
The Dutch health system used to be a 2 tiered system. High earners, approximately one-third of the population, would pay for private insurance and the rest were funded through a social security/national insurance system financed by workers and their employers.
Today
In 2006, there was a radical change. The entire system is now privately funded. The government made it compulsory for everyone to buy basic private medical insurance (called basisverzekering) and the premiums are deducted from your pay packet. The competitive market is supposed to keep the prices down.
No one can be refused insurance but if you have a pre-existing condition then you will be charged more, although there are government subsidies available.
Thoughts
I’m not really sure what the implications of this are. In many ways, it seems a kind of stealth tax – I highly doubt that social security payments went down when the new system was introduced. Also, leaving everything to the market – who is to say they will not form cartels or price fix? I can see that concerns of this were had even back in 2000: EU law makes Netherlands reconsider its health system. And I read here that prices went up by 10% after the new system.
Mind you, I found this recent article which claimed that the Dutch have the highest level of satisfaction with their health system compared to other nations: Dutch health system rated best, U.S. worst – polls.
In fact, it seems that you may even need to have health insurance to get a residency permit. Also, it is pricey at about €100 per month and a €150 excess before you can even claim anything! And people say that Dutch taxes are high enough already!
If you want to read more about the Dutch health system, I found these excellent resources:
Healthcare in the Netherlands.
Tilburg University guide including insurers and what is covered.
Anyway, at the end of the day, health insurance is totally necessary and cannot be avoided when I move to The Netherlands. A shame that it complicates further the process of emigration! Yet more red tape, unfortunately!
2 responses so far ↓
1 Eric // Jan 6, 2009 at 7:05 am
Beside the high cost EUR 100 per month, plus taxes and social security payments that are far higher than in the English speaking world, you also have to take into account what you get for that money. The answer is: very little.
The Dutch medical system is designed to make it extremely difficult for you to even get to see a specialist, let alone receive treatment. Preventative health checkups are non existent, and unless you’re visibly dying, instead of “treatment” you will usually get the advice to take it easy and come back after 6 weeks if the problem persists. Asking if they can prescribe anything to treat the symptoms while you wait may result in an incredulous, slightly alarmed “Well, I suppose it’s possible”, as if you asked them for an exorcism.
Most expats in the Netherlands return home, or visit a neighboring country when they need medical attention. Ignore that Reuters poll, Dutch people are conditioned always to rate their own country best at everything in polls. Among themselves, they complain bitterly about their medical system.
2 Chris // Jan 9, 2009 at 2:20 pm
Thanks Eric, I have heard similar since on expatica.com forums. Seems you have to fight for good healthcare!
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