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: Drinking just 1 or 2 alcoholic drinks a day linked to liver disease

Related Stories

Hackers keep trying new targets in search of easy data

Apr 14, 2015

The health care sector has become the hot target for hackers in recent months, according to researchers at Symantec, a leading cybersecurity company that says it's also seeing big increases in "spear-phishing," ...

The brave new world of big data retention

Apr 01, 2015

With the Senate passing the Federal Government's data retention bill last week, there has been a great deal of discussion of "metadata", what it is and whether the government ought to have access to it. ...

Economist probes the high cost of health care

Mar 27, 2015

When Zack Cooper arrived at Yale as assistant professor of public health and economics, he gained access to a first-of-its-kind dataset. Working with the non-profit Health Care Cost Institute, Cooper and ...

Recommended for you

Europe's police crack massive horsemeat trafficking ring

10 hours ago

Police from seven European countries detained 26 people in a crackdown on a horsemeat trafficking ring two years after a tainted meat scandal that rocked the continent, the EU's judicial agency Eurojust said Saturday.

Text messaging useful for reaching 'at-risk' teens about sex

Apr 24, 2015

Text messaging that connects teens with sexual health educators is effective for delivering sexual health information, according to a recent study in The Edward R. Murrow College of Communication at Washington State University.The ...

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.