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Health
article 13 healthcare law
excess
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NZa
rehabilitation
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University Maastricht
Wim Groot
Wednesday, 12 March 2014 - 14:15

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Study: Health premiums too pricey

Professor of health economics at the University of Maastricht, Wim Groot, claims healthcare insurance is too expensive. He claims a figure of about one billion per year is paid in excess. "If we take 10 million insurance payers, then it's 100 euro per premium payer per year." The Dutch Care Authority also recommends the law be amended so that health care insurers can buy care more effectively. "This way, the differences between packages and premiums will increase, and all those insured don't have to contribute to superfluous or ineffective care" the watchdog writes in his report on the healthcare plans which will be made public today. For this amendment of article 13 of the healthcare insurance law, the bill has been brought to Parliament. For now, the law states that the healthcare insurer must compensate if someone goes to a care institution that isn't on the contract. "Last year a health care insurer did not want to give a contract and didn't want to give low compensation to a care provider that offered rehabilitation trips to South Africa for alcohol- and drug-addicts. This because the insurer already had sufficient addiction care plans for the insured and found this care superfluous and too expensive", a spokesperson from the NZa (Dutch Care Authority) said. "The judge held the insurer to article 13 of the Health Care Insurance Law and stated that the insurer still had to compensate 75-80% of this care." This means that all Dutch care premium consumers have to contribute to these types of expensive rehab trips, or other forms of care that don't have clearly defined effects, such as tree hugging therapy. "Hereby, because institutions that aren't contracted still get 75% of the costs paid, they are less likely to improve their care or organize it more efficiently." This could have the consequence that healthcare providers offer lower quality care than the insurer would want. Premiums stay unnecessarily high as well because healthcare insurers must keep reserves to pay institutions that aren't under contract.

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