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May 13, 2008Universal Mandatory Health Insurance in The Netherlands: A Model for the United States? |
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From The Commonwealth Fund: In 2006, the Netherlands launched a sweeping national health care initiative to provide universal health care coverage for its population. According to the authors of "Universal Mandatory Health Insurance in the Netherlands: A Model for the United States?" The Dutch health care system is a work in progress. In 1941, the government introduced a mandatory health insurance plan for low- and middle-income people that provided most of the Dutch population with basic health insurance. Those with higher incomes typically purchased private insurance. As access to health care increased, so did spending, arousing fears that rising medical costs would jeopardize access to health care, inflate labor costs, and increase unemployment. In 1982, the Health Care Prices Act authorized the Dutch government to control physicians' fees and total revenues. Growing dissatisfaction with "top-down" health care rationing policies---criticized for their inability to promote efficiency and innovation---led to broad support for incentive-based reform. For example, the new system required a system of risk equalization to prevent insurers from seeking only young, healthy customers. It requires all people who legally live or work in the Netherlands to buy health insurance from a private insurance company. Employers are required to compensate their employees for these contributions. In addition, all adults are required to pay premiums directly to the selected insurer, which sets its own community-rated premium. The Dutch government has set up a Web site where consumers can compare all insurers with respect to price, services, consumer satisfaction, and supplemental insurance, and compare hospitals on different sets of performance indicators.
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