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Government financing on the Health Insurance Act in the Netherlands 2016-2020

How much money does the Dutch government spend on healthcare? In 2019, the government expected to spend a total of 50.4 billion euros through the Zvw or the Health Insurance Act. This law covers the basic health insurance in the Netherlands that all residents and employees in the country are obliged to have. The numbers shown here indicate with which sources the government planned to afford this healthcare. The government expected that most money would go towards secondary care in 2019.

Health insurance in the Netherlands: two can play that game

The health system in the Netherlands has a hybrid character. The Dutch government, on the one hand, decides the contents of the mandatory basis health insurance on a yearly basis. Health insurance companies, on the other hand, have to offer this insurance as a product. They are not allowed to leave anybody out: any Dutch citizen, regardless of age or medical records, must be accepted in this insurance. The Netherlands had 11 health insurance concerns in 2019, which owned roughly 40 companies. Health insurance concern Achmea (formerly Zilveren Kruis) had a market share of approximately 30 percent, whereas the company Achmea Zorgverzekeringen N.V. had the most gross written premiums in this insurance segment.

How does the financing work exactly?

Dutch citizens have three ways to pay for the statutory health insurance, all three of which are mentioned in this statistic. First, the income related contribution (in Dutch: inkomens afhankelijke bijdrage) is a tax that is paid from one’s salary. The majority of the healthcare financing shown here was expected to come from this source: approximately 25 billion euros in 2019. Second, the nominal premium (in Dutch: nominale premie) is paid to health insurance companies and is a national average of the basic health insurance premium that the government expects these companies to use when they offer the product. The idea behind this is that free market competition forces companies to go below this average so as to curb increasing health costs (as the companies strive to make healthcare as affordable as possible in order to attract more customers). Third, the mandatory excess (in Dutch: verplichte eigen risico) is a fee the insured (18 years and older, younger ages are exempt from this) must have paid to healthcare during the year before the insurance starts to pay out. This serves the purpose of raising awareness on how expensive healthcare is.

Government financing on the Health Insurance Act (Zvw) in the Netherlands from 2016 to 2020

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Release date

September 2019



Survey time period

2016 to 2020

Special properties

the numbers shown here indicate with which sources the Dutch government planned to afford healthcare

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Statistics on "Healthcare sector in the Netherlands"

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