Question About Dutch Health Care Reform

Wij Beatrix, bij de gratie Gods, Koningin der Nederlanden, Prinses van Oranje-Nassau, enz. enz. enz.

Allen, die deze zullen zien of horen lezen, saluut! doen te weten:

Alzo Wij in overweging genomen hebben, dat het wenselijk is dat de gehele bevolking onder voor ieder gelijke sociale voorwaarden verzekerd is tegen de gevolgen van behoefte aan geneeskundige zorg;

Zo is het, dat Wij, de Raad van State gehoord, en met gemeen overleg der Staten-Generaal, hebben goedgevonden en verstaan, gelijk Wij goedvinden en verstaan bij deze:

http://wetten.overheid.nl/BWBR0018450/geldigheidsdatum_03-01-2013

I might be just me, but haven't heard of any plans to consolidate these two agencies.
The NMA (Comp.Auth) and NZA (zorgauth.) are two very different agencies with very specific areas of expertise and focus.

I can't imagine them consolidating.

Where did you hear of such a discussion?

quote:

Op vrijdag 24 januari 2014 19:25 schreef Miguelito305 het volgende:
Hello, I am an American law student studying health care law in the Netherlands. Reform in the Netherlands is of great interest to legal research in the United States. It has come to my attention that there is current debate in the Netherlands about consolidating the Netherlands Competition Authority and the Netherlands Health Care Authority to a single agency. Unfortunately, I cannot speak Dutch, and I cannot find news articles on the subject. If you are knowledgeable generally or specifically on your health care system I would very much like to discuss it with you.

Regards,
Miguelito

Sorry for my crappy english, but i have to say the following:

Our health care seems to get worse every decade
Ok, it is still better than most parts of the world, but with that attitude the decreasing quality seems to be tolerated.

The end of the previous millenium the costs were very low (but maybe that was just all a bubble, i dont know)
Then they changed it all and made it a law to be with an health insurance company.
But the first years of those new health laws the healthy people received a no claim bonus. And they removed that also, because the health insurance companies wan t to make profit, although they say they don't. But hey, that's Dutch hypocrisy for you
So they changed it with an own-risk cost, which were higher per year.
People pay around 100 euros a month and are beginning to change their insure by increasing their own-risk costs.
And yes, the poor can ask their money back, or only a part of their money. But that's the responsibility of the state with tax-refund. Those tax-refunds for health care is appearantly in the news because EU-citizins as well as Dutch citicizins are getting it, although they dont have the right.
And yet the numbers are increasing of people who do not pay health insurance because they cannot afford it, or whatever reasons, which is strange because tax gives it all back.

And then the health insurance companies:
There are only for big ones, so it seems that there are more then 20 to choose from, but the most of them are in the hands of the for big ones.

And then if you have something, you havent got the security that health insurance covers it.
but hey, everybody just wants everybody's money, so what else is new.

So if the government wants to reform our health care yet again, it will only get worse. In the meanwhile there are sometimes articles about the health industry, wasting their electricity, medicins, buildings etc, which comes down to costs in the millions. But the health industry doesnt have to be wise with money, they get their money anyway. Appearantly by law... how sick!

[ Bericht 3% gewijzigd door CynicusRomanticusRob op 24-01-2014 21:07:10 ]

hm ok you pay only 100 euro a month but your employer pays 8% of your pay and people without work ( children , students, old people , people on welfare e.t.c ) do not pay that, that is our socialist european thing

Furthermore home's for old people , insane people and disabled are not included, there for ( AWBZ ) the employer pays also about 8% on the pay of Joe Sixpack

quote:

Op zaterdag 25 januari 2014 12:18 schreef arjan1112 het volgende:
hm ok you pay only 100 euro a month but your employer pays 8% of your pay and people without work ( children , students, old people , people on welfare e.t.c ) do not pay that, that is our socialist european thing

Furthermore home's for old people , insane people and disabled are not included, there for ( AWBZ ) the employer pays also about 8% on the pay of Joe Sixpack

The dutch healthcare system isn't payed only by insurance. The government spend every year more than 77 billion euro on healthcare.

quote:

Op zaterdag 25 januari 2014 15:08 schreef spiegelspel het volgende:

[..]

The dutch healthcare system isn't payed only by insurance. The government spend every year more than 77 billion euro on healthcare.

Roughly half of the total budget.

quote:

Op vrijdag 24 januari 2014 21:01 schreef CynicusRomanticusRob het volgende:

[..]

Sorry for my crappy english, but i have to say the following:

Our health care seems to get worse every decade
Ok, it is still better than most parts of the world, but with that attitude the decreasing quality seems to be tolerated.

The end of the previous millenium the costs were very low (but maybe that was just all a bubble, i dont know)
Then they changed it all and made it a law to be with an health insurance company.
But the first years of those new health laws the healthy people received a no claim bonus. And they removed that also, because the health insurance companies wan t to make profit, although they say they don't. But hey, that's Dutch hypocrisy for you
So they changed it with an own-risk cost, which were higher per year.
People pay around 100 euros a month and are beginning to change their insure by increasing their own-risk costs.
And yes, the poor can ask their money back, or only a part of their money. But that's the responsibility of the state with tax-refund. Those tax-refunds for health care is appearantly in the news because EU-citizins as well as Dutch citicizins are getting it, although they dont have the right.
And yet the numbers are increasing of people who do not pay health insurance because they cannot afford it, or whatever reasons, which is strange because tax gives it all back.

And then the health insurance companies:
There are only for big ones, so it seems that there are more then 20 to choose from, but the most of them are in the hands of the for big ones.

And then if you have something, you havent got the security that health insurance covers it.
but hey, everybody just wants everybody's money, so what else is new.

So if the government wants to reform our health care yet again, it will only get worse. In the meanwhile there are sometimes articles about the health industry, wasting their electricity, medicins, buildings etc, which comes down to costs in the millions. But the health industry doesnt have to be wise with money, they get their money anyway. Appearantly by law... how sick!

Crappy Dunglish or what, contentwise it's just spot on.

A consumer has a choice between only 4 big corporations. Every subbrand is just a, lets say, phoney.
This system isn't working for the people either. More nurses are fired for reasons of budgetcuts, but on the flipside more managers are hired to lead the system. The big 4 are so arrogant that they aren't searching for any kind of manner of lowering costs than to reorganise and kick every footsoldier out. Less hands on the bed, less care for the patients, less quality of healthcare overall. In stead of looking at procedures, unnecessary managementlayers or any other kinds of 'muda' in workways...

The most important thing in this system is money. Nothing else. No healthcare to patients or what so ever. For example when a patient with a really rare disease fights for here or his life and hasn't skipped a month of insurance in the healthy life, the companies are still trying to do everything to not fund the threatment. Only under the condition of an extreem outrage of the (internet) community and members of the second chamber, they fund it. And not even for the patient, nope, just on PR reasons. For themselves.

If they are making a loss, they ask the government for funding or an increase of healt insurance.
And the goverment grants it with no argument.

[ Bericht 0% gewijzigd door Red_85 op 25-01-2014 15:50:02 ]

Don't forget that we Dutch like to complain. Keep that in mind when reading about how bad we have it here.

quote:

Op zaterdag 25 januari 2014 15:45 schreef Senor__Chang het volgende:
Don't forget that we Dutch like to complain. Keep that in mind when reading about how bad we have it here.

Is allways searching for the highest quality a crime suddenly?

Was sich neckt das liebt sich Be glad they do it. If they don't it's time to start the worries.

quote:

Op zaterdag 25 januari 2014 15:47 schreef Red_85 het volgende:

[..]

Is allways searching for the highest quality a crime suddenly?

Was sich neckt das liebt sich Be glad they do it. If they don't it's time to start the worries.

It's not a crime. Just thought that OP should know about the doomsayers in this country.

quote:

Op zaterdag 25 januari 2014 15:49 schreef Senor__Chang het volgende:

[..]

It's not a crime. Just thought that OP should know about the doomsayers in this country.

Complainers or not. On the healthcare system it's granted.

quote:

Op zaterdag 25 januari 2014 15:51 schreef Red_85 het volgende:

[..]

Complainers or not. On the healthcare system it's granted.

Well, that's just, like, your opinion, man.

quote:

Op zaterdag 25 januari 2014 15:53 schreef Senor__Chang het volgende:

[..]

Well, that's just, like, your opinion, man.

hmm gaaAAAYYY!

Do you think it's perfect then, with no room for improvement?

quote:

Op zaterdag 25 januari 2014 15:43 schreef Red_85 het volgende:
Crappy Dunglish or what, contentwise it's just spot on.

Thanks

quote:

For example when a patient with a really rare disease fights for here or his life and hasn't skipped a month of insurance in the healthy life, the companies are still trying to do everything to not fund the threatment

Oh yes, i totally forgot about that and this:
When you accidently miss a payment on time in a month, the healthmaffia doesnt pay your healthbills you made in that month, but the healthmaffia makes you pay that month you missed anyway. And the law protects them.

quote:

Op zaterdag 25 januari 2014 16:01 schreef Red_85 het volgende:

[..]

hmm gaaAAAYYY!

Do you think it's perfect then, with no room for improvement?

don't pay any attention to the ignorant fools.
they appearantly lack the ability of seeing the downward spiral

i said it here:

quote:

Op vrijdag 24 januari 2014 21:01 schreef CynicusRomanticusRob het volgende:
Our health care seems to get worse every decade
Ok, it is still better than most parts of the world, but with that attitude the decreasing quality seems to be tolerated.

quote:

Op zaterdag 25 januari 2014 15:43 schreef Red_85 het volgende:

[..]

Crappy Dunglish or what, contentwise it's just spot on.

A consumer has a choice between only 4 big corporations. Every subbrand is just a, lets say, phoney.
This system isn't working for the people either. More nurses are fired for reasons of budgetcuts, but on the flipside more managers are hired to lead the system. The big 4 are so arrogant that they aren't searching for any kind of manner of lowering costs than to reorganise and kick every footsoldier out. Less hands on the bed, less care for the patients, less quality of healthcare overall. In stead of looking at procedures, unnecessary managementlayers or any other kinds of 'muda' in workways...

The most important thing in this system is money. Nothing else. No healthcare to patients or what so ever. For example when a patient with a really rare disease fights for here or his life and hasn't skipped a month of insurance in the healthy life, the companies are still trying to do everything to not fund the threatment. Only under the condition of an extreem outrage of the (internet) community and members of the second chamber, they fund it. And not even for the patient, nope, just on PR reasons. For themselves.

If they are making a loss, they ask the government for funding or an increase of healt insurance.
And the goverment grants it with no argument.

Don't pay attention to this idiot.

quote:

Op zondag 26 januari 2014 01:12 schreef TweeGrolsch het volgende:

[..]

Don't pay attention to this idiot.

Why not, troll? Try to discuss with arguments or gtfo.

quote:

Op dinsdag 28 januari 2014 01:35 schreef Miguelito305 het volgende:
In the US the fundamental problem is he lack of enforcement of regulation by the regulatory agencies themselves. You can re-tool a private system all you want but you have to vigorously enforce regulations protecting competition to avoid the same: oligopoly and cartels. Also, in my state in the US (insurance markets are provincial here) there are only a few big insurance to choose from. Unless you break them up, it will be really difficult for new entrants into the market to prosper because the big companies will use subversive methods to eliminate them. This is even with pro-competition reforms.

Do you think this what is happening in the Netherlands? I think it is interesting that a recent survey I read said that 90% of Dutch people are satisfied by the reforms. However, the fact that there are around half of insurance companies (owned by four companies) now than there was at the time of the 2006 reforms in the Netherlands is startling.

In fact, I myself wouldn't speak of a private system, since the basic health-insurance (required for every Dutch citizen to have, on penalty of a fine) is governed by Law. No insurance company can exempt ill, old or disabled people from this insurance and the elements it must contain - i.e. birthcontrol for woman and strolls for elderly people - are also dictated by the government, which are often altered after elections. With these implications, it is comparable to the dutch "privatization" of the public rail transport.

Further more, the perceived costs have risen for middle incomes, while insurance companies report losses on the basic insurance and getting their profits from the optional (unrequired) insurances, for instance to cover dental costs and physiotherapy. The tax returns (up to ¤ 66 per month) are for incomes < ¤ 20k/yr and a the standard monthly premium for health care paid by individual adults is about ¤100 per month. Since this monthly premium only covers about 45% of the total health care consumed by the people, an extra 50% is altered from payroll taxes and another 5% is added by the government to cover the total expenses the insurance companies face. Partly because of the demographic pressure (increasing life expectancy and growing part of the population above 65 years old) and partly because of the gained technological possibilities, the health care expenses have grown from 47 billion euros in 2000 to over 90 billion euros nowadays.

If you compare the expenses in the Netherlands with the expenses in the USA, we alter a smaller part of our GDP to healthcare related costs (12% vs. 17.5%) but are still above the European average. However, where an American household pays 3% of its household income to care-related costs, the Dutch households only spends only 1.5% of its household income. I think the Dutch can be very satisfied in an international context, but coming from a cheaper and collective system has made some citizens unhappy with the results since the privatization.

quote:

Op vrijdag 24 januari 2014 19:25 schreef Miguelito305 het volgende:
If you are knowledgeable generally or specifically on your health care system I would very much like to discuss it with you.

I am familiar with the US, Dutch and Japanese health care systems. I am not in favor of any of them. If your car breaks, you pay to get it fixed - a similar system when it comes to health care would not be only better for your health, but also for your wallet. If we would design the system this way, costs would drop drastically and there would be a chance that doctors would be held accountable. People who cannot afford to pay for care themselves could be subsidized.

American care is much better than Dutch care, but you pay for it through your nose. Not enough market, too much government.

quote:

Op zaterdag 25 januari 2014 15:49 schreef Senor__Chang het volgende:

[..]

It's not a crime. Just thought that OP should know about the doomsayers in this country.

Foei. TS stays TS, even in English

quote:

Op dinsdag 28 januari 2014 13:17 schreef robin007bond het volgende:
We are proud of our health care! We want to have the same system as Cuba, but the politicians are not listening to us.

It works like this. We want free health care, but we don't get it. Insane! I think that the government must spread marihuana across people all over the country. I have a fever now and I would like some weed to feel more at ease.