The philosophy underpinning the Dutch healthcare system is based upon a few 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 .
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).
In addition, there are several general laws in place (including the Competition Act/Mededingingswet) and a few specific healthcare acts (e.g. the Care Institutions (Quality) Act).
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 many 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.
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. There is a total of 24 insurance companies in the Netherlands that bear a risk for their operations.