the netherlands report compulsory costsharing in health care insurance and in exceptional medical expenses act under social security rather than under private outofpocket resulting in an underestimation of the outofpocket share data refer to total health expenditure current health expenditure plus capital formation the ccss is financed through wage taxes and general taxation as well as specific taxes such as taxes on alcohol perfumes luxury goods and products produced abroad while the private sector is financed mainly through outofpocket payments but also through private insurance schemes