page_title: Healthcare in the Netherlands
section_title: Finance
hierarchical_section_title: Healthcare in the Netherlands / Finance
caption_attribution_description: Nederlands: Collectie / Archief&#160;: Fotocollectie Anefo Reportage / Serie&#160;: Vertegenwoordigers van patiëntenorganisaties demonstreren op het Binnenhof tegen verhoging van de eigen bijdrage bij de Algemene Wet Bijzondere Ziektekosten (AWBZ) Beschrijving&#160;: Demonstrerende patiënten met spandoeken Datum&#160;: 13 oktober 1982 Locatie&#160;: Den Haag, Zuid-Holland Trefwoorden&#160;: demonstranten, demonstraties, lastenverhoging, spandoeken Fotograaf&#160;: Croes, Rob C. / Anefo Auteursrechthebbende&#160;: Nationaal Archief Materiaalsoort&#160;: Negatief (zwart/wit) Nummer archiefinventaris&#160;: bekijk toegang 2.24.01.05 Bestanddeelnummer&#160;: 932-3627
context_page_description: Healthcare in the Netherlands can be divided in several ways: firstly in three different echelons; secondly in somatic versus mental healthcare; and thirdly in "cure" versus "care". Home doctors form the largest part of the first echelon. Being referred by a first echelon professional is frequently required for access to treatment by the second and third echelons, or at least to qualify for insurance coverage for that treatment. The Dutch health care system is quite effective in comparison to other western countries but is not the most cost-effective. Costs are said to be high because of over-use of in-patient care, institutionalised psychiatric care and elderly care.
context_section_description: Health insurance in the Netherlands is mandatory. Healthcare in the Netherlands is covered by two statutory forms of insurance:
  Zorgverzekeringswet (Zvw), often called "basic insurance', covers common medical care.
  Wet langdurige zorg (Wlz) covers long-term nursing and care. (Formerly known as Algemene Wet Bijzondere Ziektekosten (AWBZ)).
  While Dutch residents are automatically insured by the government for Wlz, everyone has to take out their own basic healthcare insurance (basisverzekering), except those under 18 who are automatically covered under their parents' premium. If you don't take out insurance, you risk a fine.
  Insurers have to offer a universal package for everyone over the age of 18 years, regardless of age or state of health – in most cases it's illegal to refuse an application or impose special conditions, but not always.
  In contrast to many other European systems, the Dutch government is responsible for the accessibility and quality of the healthcare system in the Netherlands, but not in charge of its management.
  Healthcare in the Netherlands is financed by a dual system that came into effect in January 2006. Long-term treatments, especially those that involve semi-permanent hospitalization, and also disability costs such as wheelchairs, are covered by a state-controlled mandatory insurance. This is laid down in the Wet langdurige zorg ("General Law on Longterm Healthcare") which first came into effect in 1968 under the name of Algemene Wet Bijzondere Ziektekosten (AWBZ). In 2009 this insurance covered 27% of all health care expenses.
  For all regular (short-term) medical treatment, there is a system of obligatory health insurance, with private health insurance companies. These insurance companies are obliged to provide a package with a defined set of insured treatments. This insurance covers 41% of all health care expenses.
  Other sources of health care payment are taxes (14%), out of pocket payments (9%), additional optional health insurance packages (4%) and a range of other sources (4%). Affordability is guaranteed through a system of income-related allowances and individual and employer-paid income-related premiums.
  A key feature of the Dutch system is that premiums may not be related to health status or age. Risk variances between private health insurance companies due to the different risks presented by individual policy holders are compensated through risk equalization and a common risk pool. Funding for all short-term health care is 50% from employers, 45% from the insured person and 5% by the government. Children under 18 are covered for free. Those on low incomes receive compensation to help them pay their insurance. Premiums paid by the insured are, on average, €111 per month for basic health care ('basisverzekering') (about US$133 in Apr. 2018) with variation of about 5% between the various competing insurers, and a mandatory deductible ('eigen risico') of €385 (US$401) (in 2018, 2019 and 2020).
caption: Patients rights demonstration against co-pays increasing under the AWBZ, 1982
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