Patients’ association: much ambiguity over deductible adjustment

The Patients' Association of the Netherlands still has many questions about the Cabinet’s plan to introduce a maximum deductible of 150 euros per specialist treatment. For instance, there is the question of which patient group this measure is actually intended for.

Anyone who needs specialist treatment now, such as an operation, will generally lose the entire deductible in one fell swoop. The minimum deductible is 385 euros per year. Once this amount is paid, surgeries and other visits to specialists are generally free for the rest of the year. If the deductible is paid in parts however, people will be encouraged to think about the need for treatment. Therefore, the measure should help reduce healthcare costs because people will seek less specialist care, the government said.

That may be the case, the Patients' Association argued, but it's unclear which people will actually forgo such care to save money. At least for people with chronic conditions, little will change, a spokesperson explained. This concerns patients who have to be checked several times a year because of their illness or, for example, kidney patients who regularly go to the hospital for dialysis. Therefore, they still have to pay the full deductible.

"We think that the adjustment may be aimed at people with sports injuries. For example, someone who does not necessarily need an expensive scan, but could also start physiotherapy immediately," a spokesperson for the Ministry of Health explained.

Nevertheless, there are other ambiguities surrounding the rule, according to the Patients' Association. This is because although the minimum deductible is 385 euros per year, some opt for a higher amount, which can be up to 885 euros. Accordingly, it is unclear whether the 150 euros per treatment applies until the 385 euros are paid, or whether someone with a higher deductible for treatments after that must pay the balance all at once. The Association also does not know if laboratory tests, for example to test blood, are covered by the scheme.

Trade association of health insurers Zorgverzekeraars Nederland (ZN) cannot yet comment, a spokesperson said. "As soon as more details are known, health insurers will check what impact this will have on their insureds. It is not possible to say at the moment.".

The ministry spokesperson said more details on the plan will be provided in a letter to parliament next week.