Health

The healthcare insurer in the healthcare landscape: a wolf in sheep's clothing

October 1, 2013

Health care insurers announce good news: reduced premiums! But is this good news or is it simply concealing our healthcare system's weakness? The Minister affords healthcare insurers free reign to procure care from hospitals. In a 'free' market this may compromise quality. It is now time that the Minister assumes her responsibility before it is too late!

Now that the budget proposal once again shows the limits of growth in healthcare, it is essential that the discussion is clarified concerning what is meant by (limitations of) growth and who is actually in control in the healthcare landscape in the Netherlands. Will the patient now be the winner in this process, or the big loser? The Minister is only partly in control in this respect. She indirectly affords healthcare insurers free reign and they pretend it is much better than the reality by reducing healthcare premiums!

A secure business sector

Healthcare insurance in the Netherlands is a highly secure business sector. Profit may be added to the reserve and loss is absorbed by the 'stroppenpot' reserve supported by the Minister. This means that profit is more or less stable on an annual basis. Now that healthcare consumption is falling in our country and healthcare insurers collectively possess considerable reserves of hundreds of millions, the 2014 premiums have been slightly reduced. Achmea for example FBTO and Zilveren Kruis, with 5.5 million insurance clients, the largest healthcare insurer in the Netherlands, has a problem. In contrast to their competitors they have concluded hospital contracts with a contract price. This is interesting in the event of an increase in demand for healthcare. However if there is reduced demand for healthcare they pay more per procedure than for example CZ and VGZ. Let demand fall!

No crisis at Achmea. However a higher premium in the market is not handy. Then insured parties switch their health insurer in droves! So a different approach is needed. In this 'free' market sector they are are so large that in certain areas they almost have the monopoly. In negotiations with hospitals their opening bid is suddenly 15% lower than last year. Hospitals are forced to provide their care 15% cheaper, it's a question of choosing the rock or hard place. But who is actually suffering? In fact only one category: the patient! Austerity strike after austerity strike in the healthcare sector can and will ultimately lead to a decrease in the quality of healthcare. Therefore it is time that the Minister takes control and exposes the failing market forces. It is also time for the patient to carefully scrutinize his or her insurer!

This blog is also published on Skipr.nl.

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