Role and ambition
The government has the responsibility to ensure that the care provided is really effective for a reasonable price. and that we organise the care provided efficiently. The National Health Care Institute plays a crucial role in this respect. Our most important task is putting together the package of good insured care. What will be included and what not? We carry out our task within the legal and budgetary framework set down by the House of Representatives.
Increasing costs of care
The cost of healthcare in the Netherlands is increasing and this trend is expected to continue. If we do nothing, the quality of the care provided and the ability of the public to access that care will be at risk. Providing coverage for new treatments and medications under the standard health insurance package can then no longer be taken for granted, simply because we, as a society, will no longer be able to pay for it. Adjustments therefore need to be made to the manner in which we organise the care services provided. This means that all the parties concerned have to make other choices, including patients, healthcare providers, health insurers, and the government.
A more clear-cut and stronger position
The National Health Care Institute is responsible for managing the standard package of insured healthcare and is increasingly adopting a more clear-cut and stronger position in that respect. We focus a great deal of our energy on formulating the conditions for care coverage under the standard health insurance package . We analyse whether the care provided is actually effective for a reasonable price. That is and will remain the first precondition for coverage under the standard health insurance package. We will also take a careful look at the care services already included in the standard health insurance package to determine whether they meet this precondition. This often takes place only when the care in question is initially included in the standard health insurance package. This is something that has to change. With regard to the care covered under the standard health insurance package, we will also be more frequently taking a careful look at whether the care is actually effective or whether a better or cheaper alternative is available under the standard health insurance package.
Appropriate care is the unifying theme underlying all the tasks of The National Health Care Institute. As the party responsible for putting together the package of insured care, we will continue to put more emphasis on asking whether the care provided is actually appropriate. Is a treatment properly organised and appropriate to the needs of the patient in question? Does the treatment contribute to the self-reliance/independence of the patient and help to prevent more serious care needs in the future? Agreements in this regard are already being reached in many sectors in the form of quality frameworks and guidelines. As far as we are concerned, these agreements will be applied more frequently and more rigorously to determine whether the cost of care is covered under the standard health insurance package.
Quality framework for Appropriate care
We also undertake other activities aimed at improving the quality and accessibility of insured healthcare in the Netherlands, with the concept of Appropriate care serving as the guideline. We regularly publish updates on questions such as how the goal of making care more appropriate can be realised in practice in a specific area of care, such as cancer or cardiovascular diseases. By doing so, we encourage healthcare professionals to make the care provided more appropriate. We also think it is important for all the parties involved in the care sector to agree on a generally applicable Appropriate care Quality framework. Such a framework would serve as a guideline for all parties in the care sector as well as for us as the party responsible for managing the insured care package. This will enable us, step-by-step, to ensure that all the insured care provided is actually effective for a reasonable price, is organised efficiently, and is appropriate to the specific needs of the patient in question.