{"id":721,"date":"2008-11-10T13:04:00","date_gmt":"2008-11-10T17:04:00","guid":{"rendered":"http:\/\/blog.cmhughesmd.com\/?p=721"},"modified":"2008-11-10T13:04:00","modified_gmt":"2008-11-10T17:04:00","slug":"the-netherlands-oecd-summary","status":"publish","type":"post","link":"http:\/\/blog.cmhughesmd.com\/?p=721","title":{"rendered":"The Netherlands &#8211; OECD Summary"},"content":{"rendered":"<p>Summaries of summaries of healthcare systems based on the Commonwealth Fund reports.<br \/>Author(s) of <a href=\"http:\/\/www.commonwealthfund.org\/topics\/topics_show.htm?doc_id=674975\">the originals <\/a>are: <br \/>Karsten Vrangbaek, Isabelle Durand-Zaleski, Reinhard Busse, Niek Klazinga, Sean Boyle, and Anders Anell <\/p>\n<p>Netherlands<br \/>\u2022 The Netherlands will be experiencing major changes that began in 2006 due to dissatisfaction with the prior dual system of competing public and private health care.<br \/>\u2022 All residents are required to buy health insurance.<br \/>\u2022 Health insurance is &#8220;statutory&#8221; but provided by private health insurers and regulated under &#8220;private law&#8221;.(?)<br \/>\u2022 Financing: statutory health insurance, or SHI or public insurance is funded by a 6.5% tax on taxable income up to \u20ac30,000.  This 6.5% apparently must be reimbursed by the employer however.<br \/>\u2022 The self-employed pay a 4.4% rate of tax for their insurance on their income.<br \/>\u2022 The average annual premium as of 2006 was \u20ac1050<br \/>\u2022 The government completely covers children up to age 18.<br \/>\u2022 &#8220;Substitutive&#8221; private health insurance was abolished in 2006.<br \/>\u2022 The statutory health insurance fund distributes risk-adjusted funds to the insurers.  These insurers also provide, for a fee, complementary\/supplementary insurance.  The premiums for these complementary policies are not yet regulated.<br \/>\u2022 Private insurers may be for-profit but must accept everyone in their geographic area.  They are compensated for this by risk adjustment reimbursement by the government.<br \/>\u2022 78% of total health care expenditure is public.<br \/>\u2022 The statutory health insurance covers usual healthcare and includes drugs but does not include routine dental care.  The annual deductible is \u20ac150 per year.<br \/>\u2022 Out-of-pocket expenditures account for 8% of the total health expenditure of the Netherlands<br \/>\u2022 Physicians contract directly or indirectly with insurers.  General practitioners income is a combination of capitation and fee-for-service and pay-for-performance is being tried.  Specialists are two thirds self-employed even if hospital-based and one third are salaried.<br \/>\u2022 Hospitals are mostly private but not for profit.<br \/>\u2022 Cost controls: it sounds like they are working on a version of managed competition though I am not clear on that.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Summaries of summaries of healthcare systems based on the Commonwealth Fund reports.Author(s) of the originals are: Karsten Vrangbaek, Isabelle Durand-Zaleski, Reinhard Busse, Niek Klazinga, Sean Boyle, and Anders Anell Netherlands\u2022 &hellip; <a href=\"http:\/\/blog.cmhughesmd.com\/?p=721\" class=\"more-link\">Continue reading<span class=\"screen-reader-text\"> &#8220;The Netherlands &#8211; OECD Summary&#8221;<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"sfsi_plus_gutenberg_text_before_share":"","sfsi_plus_gutenberg_show_text_before_share":"","sfsi_plus_gutenberg_icon_type":"","sfsi_plus_gutenberg_icon_alignemt":"","sfsi_plus_gutenburg_max_per_row":"","footnotes":""},"categories":[125,131,60],"tags":[],"class_list":["post-721","post","type-post","status-publish","format-standard","hentry","category-netherlands","category-oecd-summaries","category-us-world-health-care-policy"],"post_mailing_queue_ids":[],"_links":{"self":[{"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=\/wp\/v2\/posts\/721","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=721"}],"version-history":[{"count":0,"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=\/wp\/v2\/posts\/721\/revisions"}],"wp:attachment":[{"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=721"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=721"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=721"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}