Netherlands

Owned by Federica Andreoni
Last updated: Nov 04, 2024
4 min read

Country’s healthcare system in a nutshell

In the Netherlands, the healthcare system combines public funding with private insurance. Every resident must obtain statutory health insurance from private insurers, who are mandated to accept all applicants. The system is mainly funded through public sources, including premiums, taxes, and government grants. The national government sets healthcare priorities and oversees aspects of access, quality, and costs. Standard benefits include hospital care, physician services, home nursing, mental health care, and prescription medications. While adults are responsible for paying premiums, annual deductibles, and coinsurance or copayments for certain services and drugs, the government covers healthcare costs for children up to the age of 18.

The national government is tasked with establishing healthcare priorities, implementing legislative changes as needed, and overseeing the market-based system's access, quality, and cost aspects.

Municipalities manage specific health services, such as preventive screenings and outpatient long-term care, while the Federal Ministry of Health takes on a regulatory role rather than managing healthcare directly.

Several independent bodies set operational priorities:

  • The Health Council provides guidance to the government on evidence-based medicine, public health, and environmental protection.

  • The Medicines Evaluation Board ensures the efficacy, safety, and quality of medicines.

  • The National Health Care Institute evaluates new technologies for effectiveness and cost and advises on their inclusion in the mandatory benefit package.

  • The Dutch Health Care Authority oversees the functioning of health insurance, purchasing, and care delivery markets.

  • The Dutch Competition Authority enforces competition laws among insurers and providers.

  • The Health Care Inspectorate monitors the quality, safety, and accessibility of care. Self-regulation by medical professionals is also a key element of the system.

Health information technology (IT) is not centralised. The Union of Providers for Health Care Communication manages the data exchange through IT infrastructure.

(Tikkanen et al., 2020)

According to the most recent data from 2010, health insurance covered 98.9% of the population in the Netherlands. This coverage encompasses both those who are members of health insurance schemes and those who have free access to state-provided healthcare services (Our World in Data, n.p.).

Public vs private

Health care spending by country in 2021 (6).svg
Source: The World Bank.
The pink column refers to the public expenditure as a % of the country’s total healthcare expenditure. The blue dot is the country’s expenditure on health per capita, expressed in international dollars at purchasing power parity.

The national PHR

History

In 2011, initial discussions began in the Netherlands about creating a national Electronic Patient File (EPD), which would standardise medical records for every patient and enable them to access their medical data. However, this project failed to gain support from the Senate.

In response, the Dutch Patient Federation introduced an alternative solution: MedMij and the personal health environment (PHE) (PGO.nl, 2023).

The MedMij foundation was established in 2015 by the Informatieberaad Zorg (Healthcare Information Council), a collaborative body involving various stakeholders from the healthcare sector and the Ministry of Health, Welfare, and Sport. This initiative, led by the Patiëntenfederatie Nederland (Dutch Patients Federation), aims to set standards for the secure exchange of health data in the Netherlands.

Currently, MedMij represents the benchmark for the secure transmission of health data between patients and healthcare providers. Organisations that meet the stringent criteria set by MedMij are authorised to use its label. This certification ensures that individuals can access their health data through a personal health environment (PHE) of their choosing. The MedMij label denotes adherence to the standards outlined in the MedMij Framework. It is awarded to apps, websites, or PHEs that meet these requirements and is also displayed at healthcare providers' locations that participate in the MedMij network.

While the MedMij label guarantees secure data exchange, it does not provide information about the functionality or user-friendliness of the certified tools. Patients are responsible for selecting the app or website that best suits their needs.

(MedMij, 2023)

At present, there are 13 PHEs that meet MedMij standards, offering patients a choice of platforms. An updated list is available here: MedMij Participants.

Investments

The Dutch Ministry of Health, Welfare, and Sport (VWS) has made significant investments in healthcare digitalisation in recent years. One of the major initiatives is the Dutch Health Information Council, which oversees the National Health Information Exchange Infrastructure (VIPP) program. This program has received substantial funding to improve digital information exchange across healthcare providers, enhancing patient care and efficiency (VIPPGGZ, n.d.).

In total, the VWS has allocated around €900 million to various digital health initiatives. The VIPP program itself was initially funded with €400 million, aimed at upgrading hospital information systems, improving patient access to medical records, and facilitating inter-organisational data exchange. Of this, hospitals (VIPP 1) received €105 million, while GPs were allocated €75 million.

Additionally, €75 million has been earmarked for artificial intelligence in healthcare and digital innovation, focusing on areas such as telehealth, digital diagnostics, and personalised medicine. These investments are part of a broader strategy to modernise the healthcare system, making it more resilient and efficient through technology.

Overall, the VWS's efforts reflect a strong commitment to integrating digital solutions within the healthcare sector, aiming to improve efficiency and support population health management.

(PKB interviews)

Bibliography

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