Cabinet moving forward with heavily criticized healthcare system changes

The government is pushing through with its plans to change the healthcare system. The final version of the Integrated Healthcare Agreement (IZA) differs little from the heavily criticized draft that leaked last month, NRC reports.

In the IZA, Minister Ernst Kuipers of Public Health and the healthcare sector made agreements for the next four years with the aim to keep healthcare accessible and costs in check. The agreement is currently with sector parties like GPs and district nurses. They’re expected to sign it next week.

According to the newspaper, the IZA boils down to people who are ill being more self-reliant in the future. They’ll have to find answers online or get a digital consultation with the GP instead of heading straight to the doctor’s office. They may have to travel further for the necessary care and pay more if they choose a healthcare provider outside their health insurer’s network. All of these points were criticized in the draft agreement and still exist in the final IZA, NRC said.

General practitioners' and district nurses’ budgets will still get cut. But health insurers must give GPs more time with patients from next year, a great wish of the general practitioners. And at the last minute, the Ministry promised to invest 48 million euros into the nursing sector.

The IZA also limits the free choice of doctors. Health insurers won’t have to reimburse as much of the costs if their customers pick a doctor that the health insurer doesn’t have a contract with. And in the future, patients must first ask their insurer to approve a quote from a non-contracted healthcare provider before they start the care process. This should prevent people from being faced with unexpected costs, but Ger Jager of the Foundation for Maintaining Free Choice of Doctor called it “bizarre.” “How can you make a quote without a diagnosis? And how can you make a diagnosis without seeing the patient?”

The IZA also focuses on concentrating healthcare. Health Minister Kuipers believes that healthcare will improve if hospitals provide fewer treatments, thereby specializing in the care they do offer. That means complicated treatments will be performed in fewer places in the Netherlands in the future, resulting in patients likely having to travel further for needed care.

Emergency care will be “dramatically transformed,” because the current system is stalled with too few staff and rising demand. The idea is that not everyone who needs urgent care goes to the fully equipped emergency room - district nurses, midwives, GPs, and rehabilitation doctors will take over some of the emergency care.