Two-tier Health Care - Netherlands

Netherlands

Health care in the Netherlands is essentially single tier with all persons accessing a common system of private and public providers with complete freedom of choice between providers. Insurers are all private companies. This insurance is heavily subsidized from tax revenues and heavily regulated, with a common, regulated standard insurance policy coverage set nationwide for all providers and a more flexible top up insurance which is less regulated and set by each company as it chooses.

Insurers set a standard price for each adult for the year for a given region of the country and have to insure all people who apply for insurance at that price regardless of the age or health status of the applicant. An equalization fund, which is essentially a national sickness fund funded from a form of income tax on employers and employees is used to pay for the health care of all Dutch children and to compensate insurers if they have more high risk profile clients than the other insurers. Thus Dutch insurers welcome the sick and the elderly because they are fully compensated for the higher risk profile of these clients. People living in more expensive areas of the country have to pay higher premiums but the elderly and the sick pay the same premiums as everyone else in that region. Social insurance covers the insurance costs of those with limited incomes such as the unemployed and the permanently disabled.