Going Dutch: Netherlands' Health Reforms Might Be Worth Studying

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<p>Two years ago, the Netherlands launched a sweeping national health care initiative to provide universal health care coverage for its population. Not a single-payer system, the Dutch approach combines mandatory universal health insurance with competition among private health insurers.<br><br>According to the authors of "<a href="/publications/in-the-literature/2008/may/universal-mandatory-health-insurance-in-the-netherlands--a-model-for-the-united-states
">Universal Mandatory Health Insurance in the Netherlands: A Model for the United States?</a>”, published today by <em>Health Affairs,</em> the Dutch system is a model that may be of particular interest to policymakers in the U.S. as they search for ways to address stubbornly high uninsured rates and a shortage of affordable coverage. "Knowledge of the Dutch health system may contribute to the broadening of U.S. policy debates," say the authors of the Commonwealth Fund-supported article, Wynand P. M. M. van de Ven, Ph.D., and Frederik Schut, Ph.D., of Erasmus University in Rotterdam.<br><br>The new Dutch law requires all people who legally live or work in the Netherlands to buy health insurance from one of a number of competing private insurance companies, which are required to accept each applicant. The government has set up a Web site where consumers can compare all insurers and all hospitals on various performance indicators and other criteria.<br><br>To finance the reform, individuals make annual income-based contributions through the tax system (for which employers are required to provide compensation). These contributions in turn are transferred to a "risk equalization" fund that compensates insurers for taking on high-risk enrollees. In addition, all adults pay premiums to their insurer, which sets its own community-rated premium.<br><br>"The Dutch system contains many features worthy of closer study by policymakers in the U.S.," says Fund president Karen Davis. "It succeeds in providing quality insurance coverage, at affordable cost, to nearly all its citizens--while continuing to have private insurers play a leading role."</p>