The Netherlands
In the Netherlands, access to care is based on a three-tiered classification system. Primary mental and physical care is the first tier – this sector is mainly composed of general practitioners. Accessing the other two tiers, including short-term care or “cure” and longer-term care, requires a referral from a general health practitioner. Financing for these services are provided by a payment system that was introduced in 2006. Long-term care, which might include hospitalization over several months or permanent disability costs, is covered by mandatory state-operated insurance. This kind of care accounted for 27% of all insurance-covered healthcare expenses in 2009. Accessing short-term care requires mandatory health insurance that is purchased from private sources, which covered 41% of all medical expenses in 2009. The remainder of healthcare expenses are paid for out of pocket, with taxes, or supplementary health insurance plans.
Healthcare Spending
Like many other European nations, the Netherlands spends a high amount of money on healthcare costs. In 2012, the country spent 12.4% of the national GDP – a total of $5,385 USD per person. The CIA World Factbook ranks the Netherlands as 9th in the world with respect to healthcare spending. The U.S. is one of the only other high-income, populous nations to spend more on healthcare. Critics have suggested that spending is so high because the system is inefficient.
Availability of Care
There are 3.92 physicians per one thousand people in the Netherlands. This figure indicates a doctor-to-patient ratio of about 1:255, which is above the regional average of 1:302 across the European region. Indeed, many high-income countries around the world, including the United States and Canada, suffer from physician shortages. Additionally, the number of nurses and midwives in the country is also high, with 8.83 nurses and midwives per one thousand people. This statistic is again higher than the average across the region, which is 8.05 nurses and midwives per one thousand people.
Life Expectancy & Mortality
As is the case with most high-income European nations, the Netherlands has a high life expectancy. Dutch infants born in 2014 can expect to live for 81.12 years, a figure that varies by gender. Females can expect to live 83.34 years and males can expect to live 79.02 years. The CIA World Factbook ranks the Netherlands as having the 22nd highest life expectancy in the world. Neighboring countries Spain, Norway, and France also have life expectancies between 81 and 82 years.
Other Issues
The health care system in the Netherlands has been described as effective. The reforms that took place in 2006 helped to address many of the problems that had been plaguing the system for years; namely, long wait times, a lack of general public knowledge regarding quality of care, and unequal access to services for high-risk citizens who were privately insured. While those issues have been addressed, the compromise that came with the reform was a decrease in the cost-effectiveness of the system. Healthcare spending continues to increase in the Netherlands, where it is already among the top ten countries in the world. This has caused some to question how financially sustainable this system is.