The number of Dutch people who forgo care because of the costs is slowly increasing. This is evident from an annual survey by the Nivel knowledge institute.
For fear of the bill, more than one in ten people did not go to a doctor last year, did not undergo a medical examination or did not take certain medications.
33-year-old Walter van de Kruk can talk about it. He has to take muscle relaxants daily for his joint problems, but has to pay for these pills himself because they are not reimbursed. He says he can’t do that. “I now only take them if there really is no other option,” he says. This means that Van der Kruk now lasts almost four months with a box of pills that is intended for three weeks.
Increasing trend
The Nivel poll shows that there has been a slightly increasing trend since 2020. The Netherlands Patient Federation is very concerned about this group of Dutch people. “Our own research from 2023 shows that one in five Dutch people postpone visits to a doctor because of the costs, such as the deductible that they then have to pay,” says director Arthur Schellekens. “But our panel includes many people who need care more than average.”
For this group, the deductible has ‘an enormous impact’, says Schellekens. “People who are ill often have a harder time financially. They cannot work or work less. In addition, the costs of daily living are often higher due to their illness.”
Two years ago, Van der Kruk was completely rejected because he suffers from several serious conditions. For example, he has an eye disease that leaves him with only five percent vision, an autoimmune disease and he suffers from joint problems. Because he can no longer work, he has to survive on Wajong benefits. And that is sometimes not easy. For example, he pays for his mobility scooter, has expensive health insurance and pays a personal contribution for home care. He sometimes has to make difficult decisions.
“Two years ago I needed glasses that would allow me to see thirty percent again,” says Van der Kruk. “But I couldn’t pay him.” Only last week did he find an optician where he can buy the glasses on credit.
For people who make ends meet every month, the mandatory deductible is an almost unsurmountable hurdle. The Patient Federation therefore advocates a significant reduction.
Abolition or reduction
Yet the question is whether abolition or reduction is so much better, since this costs hundreds of millions to billions of euros per year and that money must be found elsewhere. “An increase in the monthly health insurance premium is then almost inevitable,” says health economist at Maastricht University Wim Groot. And many healthcare experts agree with him.
“That really is a political choice,” says Schellekens. “These costs can be collected through health insurance premiums, but this can also be done through other taxes.”
According to the CPB, abolition of the deductible costs 3.6 billion euros per year, plus an increase in healthcare expenditure of 2.1 billion euros per year because the barrier to going to the doctor disappears. A total of around 6 billion euros must be raised if the deductible is abolished.
