The Dutch government decides on the cover provided by this package and health insurance companies are obliged to accept everyone who meets the requirements, regardless of age or state of health. An important characteristic of Dutch health insurance, though, is the so-called "principle of social solidarity": the overall costs of health care are paid by everybody. It is since 2008, for example, compulsory from the age of 18 to pay a total mandatory excess before the basic health insurance reimburses medical costs. In this way, everybody contributes to certain types of healthcare such as maternity care.
In 2017, the total mandatory excess reached a value of 385 euros. In 2005, the total health expenditure as share of GDP in the Netherlands reached a value of approximately 12 percent. Subsequently, this increased to approximately 14 percent in 2015. In 2017, the gross government expenses for primary care reached a value of approximately 5.5 billion euros.