The Dutch healthcare system

The philosophy underpinning the Dutch healthcare system is based on several more or less universal principles: access to care for all, solidarity through medical insurance (which is compulsory for all and available to all) and high-quality healthcare services. Inevitably, the Dutch system has also been shaped by a number of historical trends and developments and social conditions.

Foundation of the healthcare system

The Dutch healthcare system is governed by four basic healthcare-related acts: the Health Insurance Act (Zorgverzekeringswet), the Long-Term Care Act (Wet langdurige zorg), the Social Support Act (Wet maatschappelijke ondersteuning) and the Youth Act (Jeugdwet).

The four healthcare-related acts form the foundation of the Dutch healthcare system. The Health
Insurance Act (which provides for hospital care) and the Long-Term Care Act (which focuses on
other types of care) account for the bulk of the healthcare budget available in the Netherlands.
The Long-Term Care Act is a national act governing healthcare throughout the Netherlands.
In implementing the Health Insurance Act, private health insurance companies play a key role in
a system based on “regulated competition” and a number of specific public requirements.
The Social Support Act and the Youth Act provide for other forms of care and support. The roughly
400 municipalities in the Netherlands are primarily responsible for enforcing these two acts.

Principles of the Dutch Healthcare System

The current Dutch healthcare system can best be explained by looking at a number of recent
changes. In 2006 the new Health Insurance Act entered into force, under which all residents of
the Netherlands are entitled to a comprehensive basic health insurance package. This act is
implemented by private, competitive health insurers and healthcare providers. It should be noted
that virtually all health insurance companies in the Netherlands are not-for-profit cooperatives
that allocate any profits they make to the reserves they are required to maintain or return them in
the form of lower premiums.

Long-term care, youth health services and social support

The Long-Term Care Act, the Social Support Act and the Youth Act were introduced more recently,
having entered into force in their present form in 2015. The Long-Term Care Act is administered by
special long-term care administrators at the behest of the central government. Additionally,
several other organisations are involved in its implementation, such as the Centraal
Indicatiestelling Zorg (Care Assessment Agency) and the Centraal AdministratieKantoor (Central
Administration Office). The local authorities are responsible for implementing the Social Support
Act and the Youth Act – they provide the support, assistance or care services or are supported in
this process by a healthcare provider.

The motivations behind these laws are opportunities to improve the quality of the care provided,
promote an integrated approach, and keep healthcare available and affordable in times of an
ageing population and in which many people suffer from chronic illnesses. The foundation of
these domains are people’s opportunities rather than their shortcomings. Initially, people are
encouraged to draw on their own network and resources for support, but support is always
available for those unable to secure it themselves. Those requiring permanent supervision or
24-hour home care are entitled to care services under the Long-Term Care Act.

The text above is an abstract from a publication of the Ministry of Public Health, Welfare
and Sport. Read the full text in the publication 'Healthcare in the Netherlands'.

National Health Care Institute

The National Health Care Institute (Zorginstituut Nederland) carries out tasks relating to two Dutch statutory health insurance schemes: the Health Insurance Act (Zorgverzekeringswet) and the Long-Term Care Act (Wet langdurige Zorg, Wlz). Read more on these tasks on the webpage 'Tasks of the National Health Care Institute'.