Health minister: Ending health insurance deductible would cost €300 per person annually

A popular political proposal to eliminate the health insurance deductible in the Netherlands would cost each resident about 300 euros per year, said caretaker Health Minister Ernst Kuipers. The motion to cancel the own-cost portion of health insurance, known as eigen risico, would end up helping those who actively receive healthcare at the expense of those who do not, Kuipers wrote in a letter to parliament last week.

The health insurance deductible was fixed at a minimum of 385 euros for 2023, and will not increase next year. The amount is paid on top of health insurance premiums, and people can also opt for a higher deductible to pay a lower monthly premium. Earlier in December, SP party leader Jimmy Dijk introduced a motion in the Tweede Kamer, the lower house of Parliament, in which he said the health insurance “deductible is a reason for one in four people to avoid care.”

Proposal would cost billions, and individuals would pay €300 per year to cover it

Dijk's motion called for the outgoing Cabinet to immediately abolish out-of-pocket payments for healthcare, saying that the cost of living issues in the Netherlands are too acute, and residents "cannot wait" to get relief until a lengthy Cabinet formation process is completed. The motion won support from 80 Members of Parliament on the right and left.

"Abolishing the deductible will increase collective healthcare expenditure. This can put pressure on affordability, and therefore also the accessibility and quality of care, in the longer term," Kuipers wrote. "Abolishing the mandatory deductible is expected to cost approximately €6 billion per year and will lead to a significant increase in premiums," he continued.

"The premium will increase by approximately €300 per person per year as a result of the elimination."

Kuipers: Healthcare payments in the Netherlands are much lower than the EU average

Kuipers disagreed with the premise of the motion, saying, "The deductible in an accessible and affordable healthcare system." He noted that out-of-pocket payments account for roughly 9 percent of healthcare costs, where the average in other European Union countries is closer to 18 percent.

Part of the reason this amount is lower in the Netherlands is because visits to the family doctor, maternity care, and community nursing are already exempt from the deductible, Kuipers argued. Abolishing the own-cost portion of health insurance could lead to healthcare expenditure spiraling out of control if people were to seek out unnecessary treatments because they are no longer aware of the costs involved.

The D66 minister also argued that "only some" would benefit from the elimination of the deductible. "People who do not use care will suffer financially compared to people who do use care," Kuipers said.

The health minister told the Tweede Kamer that abolishing the deductible would require amending the Health Insurance Act (Zvw), which could take at least 18 months to work its way through the political process. That would be in addition to finding the means to pay for the decision in the budget.

During a political debate on the measure, PvdD party leader Esther Ouwehand blamed Prime Minister Mark Rutte's VVD for problems caused by the deductible. “They have put everything up for sale, which means that people in the Netherlands are faced with a lack of housing, among other things. They have stripped healthcare, including care for the elderly. They have introduced the deductible,” she said. Her argument was a rebuke against PVV party leader Geert Wilders, whose party voted in favor of Dijk's motion, while simultaneously saying they want to form a new Cabinet with the help of the VVD, and likely also the NSC and BBB.

PVV's 37 MPs voted in favor of Dijk's motion. They were joined by GroenLinks-PvdA (25), BBB (7), SP (5), Denk (3), and PvdD (3). Those opposed include the VVD (24), NSC (20), D66 (9), CDA (5), FvD (3), SGP (3), ChristenUnie (3), Volt (2), and Ja21 (1).