Health policy expert says US can learn from Dutch universal healthcare coverage

Dec 06, 2008

The United States can learn from the Dutch Health Insurance System model, according to an article by Pauline V. Rosenau, Ph.D., in the December issue of the Journal of Health Politics, Policy and Law.

Rosenau, professor of management, policy and community health at The University of Texas School of Public Health at Houston, co-authored the lead article, which discusses universal health care coverage in the Netherlands and its possible lessons for the United States.

The article examines the 2006 Enthoven-inspired Dutch health insurance reform, which is based on regulated competition and requires individuals to purchase basic insurance policies. The structure of the Dutch model provides insight into the effects that universal health care reform could have in the United States, Rosenau said.

"Although this type of reform is important and critical, policymakers must think carefully on how it is done," she said.

According to Rosenau's evidence-based assessment, U.S. policymakers seeking to establish universal health care should be aware that, according to the Dutch model, it may not control costs. Insurance companies have seen profit loss on basic policies, health care providers are in opposition and public satisfaction is not high in the Netherlands.

"The Netherlands is the best test of market competition-based health insurance reform to date," Rosenau said. "But U.S. policymakers should be careful with this form of universal coverage because it has failed, so far, to reduce costs or improve quality."

However, according to Rosenau, the quality and access to health care is sometimes better in the Netherlands, while the healthcare cost per person is half the amount of the United States.

"We suspect that if patient satisfaction with the Dutch healthcare system has not declined dramatically since the insurance reform (and surveys provide conflicting findings), it is because of a dedicated 'army' of primary care physicians who remain committed to their patients. An excellent example is the after-hours care provided by Dutch primary care physicians," says Rosenau.

With several industrialized countries providing universal health care coverage, Rosenau believes the Netherlands' model closely resembles the model that U.S. policymakers are looking to create.

The Dutch Health Insurance System requires regulated sale of health insurance policies and makes the purchase of basic health policies mandatory by implementing fines and penalties for those who ignore the law. The basic policy requires services such as primary and specialist care, hospitalization for up to one year, maternity care, ambulance service and prescription pharmaceuticals. For basic health insurance policies, there are no limitations on preexisting conditions. Citizens can purchase supplementary coverage for procedures such as cosmetic surgery or expanded dental or vision care, but insurance companies are able to choose the patients they want to cover.

Source: University of Texas Health Science Center at Houston

Explore further: Public overinflates time spent by dermatologists on cosmetic Tx

add to favorites email to friend print save as pdf

Related Stories

Report: Better shields needed for private tax data

Oct 23, 2014

Federal investigators say the IRS and the states should improve how they protect the security of confidential tax information of people getting benefits under the 2010 health care law.

Three hours of life per euro

Oct 15, 2014

Public spending appears to have contributed substantially to the fact that life expectancy in eastern Germany has not only increased, but is now almost equivalent to life expectancy in the west. While the possible connection ...

UnitedHealth tops 3Q expectations, raises forecast

Oct 16, 2014

UnitedHealth Group's third-quarter earnings inched up 2 percent but that was enough to help the nation's largest health insurer trump Wall Street expectations and raise its 2014 forecast for the first time ...

Recommended for you

AMA 'Code of Ethics' offers guidance for physicians

1 hour ago

(HealthDay)—The American Medical Association (AMA) Code of Ethics and other articles provide guidance for physicians in relation to public health emergencies, according to a report from the AMA.

Pot-infused edibles: One toke over the line in Colorado?

5 hours ago

Marijuana shops have sprouted across Denver ever since Colorado legalized the drug for adults in January, but the popularity of pot-infused edibles has surprised authorities, and parents are seeking a ban ahead of Halloween.

US sues Gerber over claims on infant formula

7 hours ago

U.S. government regulators announced Thursday they were suing Gerber, the well-known baby food maker, for claiming that its Good Start Gentle formula can prevent or reduce allergies in children.

User comments : 1

Adjust slider to filter visible comments by rank

Display comments: newest first

lengould100
not rated yet Aug 18, 2009
makes the purchase of basic health policies mandatory by implementing fines and penalties for those who ignore the law.


"fines and penalties"?? Who's going to choose not to purchase? Almost exclusively poor people taking a bad gamble on not getting ill, plus a few young yuppie risk-takers. Why the heck make it optional at all? Simply make it universal and tax funded. MUCH cheaper administration, no questions of coverage proof except residence.

Dummies. It's how we do it in Canada, run by provincial (eg. state) governments and works very well.

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.