National health expenditure in the Netherlands 1998-2022

In 2022, the national healthcare expenditure reached a value of more than 107.6 billion euros, nearly equaling the amount spent in the previous year. In a population of over 17 million people, this came to around 7,116 euros worth of Dutch health care expenses per capita. This figure was higher than those of other European countries. The per capita health expenditure of Italy, for example, stood at slightly over 2,800 euros in 2021, less than half that of the Netherlands. There are some who say, however, that this difference in health costs stems from how Dutch health insurance works.

Dutch health insurance: one for all, all for one

The Dutch health system combines private market elements with government supervision to make health care cost-efficient. Simply put, the Dutch government decides which care is covered by the mandatory “basic” health insurance. This can change every year and be influenced by politics. Therefore, health care in the Netherlands is accessible to (and paid for by) everybody, whether one uses it or not. This system is funded in three ways. First, there is a nominal annual premium of more than 1,500 euros (or 125 euros per month) that everybody pays, regardless of age or job situation. Second, some employers pay health care costs, depending on certain industries. Third, there is what is called eigen risico or “own risk”/”excess”. This lump sum is compulsory from the age of 18 to pay before the basic health insurance starts reimbursing medical costs. In 2021, the value of this “verplichte eigen risico” was 385 euros. This is without counting the price a health insurance company might charge.

Dutch health care: getting what one pays for

The government decides the contents of the national health insurance package. Quality and pricing, however, are left to the health providers and health insurers. This is the other idea behind health care in the Netherlands: it should be accessible to all, but the free market is responsible for assuring quality and low costs. Dutch health care ranked as some of the best found in Europe, and the Dutch used it relatively often as can be seen in an overview of doctor visits in different European countries.