Dutch health system 'flawed'

THE GOVERNMENT should “think twice” about introducing a Dutch-style health system because of escalating costs and a lack of choice, a conference was told last week.

Michel Dutrée, the chief executive of Nefarma, the Dutch pharmaceutical industry lobby group, said the health model adopted by his country looked good in principle but was flawed in practice.

“I would urge Irish people to think twice. You need a working system and insurance companies that are really interested in competing with each other and offering quality. Governments should only focus on outcomes of care for the patients,” said Mr Dutrée.

In 2006 the Dutch introduced a model of private-public healthcare with private insurance companies competing to access public health services. The model has been praised for guaranteeing universal access and has high levels of satisfaction. It has been frequently cited by the Minister for Health, James Reilly, as a model Ireland should aspire to.

However, Mr Dutrée told the annual conference of the Irish Pharmaceutical Healthcare Association (IPHA) that healthcare in the Netherlands was now based on cost rather than need.

He said the projected costs of healthcare there would double in the next 10-15 years. If nothing is done, Dutch people will be spending 25 per cent of their annual income on healthcare, more so than in the United States.

Mr Dutrée maintained that, far from increasing competition, the 35 insurance companies which started out providing cover in 2006 have now been reduced to just four and all are offering premiums within €10 of each other.

Basic cover for an adult in The Netherlands is €1,211 which has risen by only 9 per cent since 2007, but the cost of add-ons such as dental care and physiotherapy has risen by up to 50 per cent in the same timeframe and now cost an average of €1,500 a year.

In addition, the basic cover package is being shrunk by the Dutch government. Children are free, but add-on packages are not. He said it was becoming more difficult to get insurance companies to fund innovative drugs and the price of generics was now cheaper than chewing gum in many cases. There was also a shortage of doctors in The Netherlands and too many hospitals.

“Basically you hand over your life to the insurance companies and a public system executed privately is very difficult to manage,” he added.