Health insurer must mediate in long waiting lists: ‘Doesn’t always work in practice’ | Healthy

Health insurer must mediate in long waiting lists: ‘Doesn’t always work in practice’ | Healthy
Health insurer must mediate in long waiting lists: ‘Doesn’t always work in practice’ | Healthy

The long waiting lists at mental health care have been a problem for some time. When it comes to psychological help, you want to get the care you need quickly. Are you on such a waiting list and do you want to know where you stand? We asked experts if there’s anything you can do.

Research shows that there are approximately twice as many people who are entitled to care from mental health care than the number of people who currently use it. It would be about 80,000 people. More money is needed to change that.

If you are on a waiting list, it is good to know that there is a maximum waiting time, says Bas Knopperts, health insurance expert at Independer. This is established in the so-called Treek standards. They come down to this:

• There may be a maximum waiting time of four weeks between the time you call and your first appointment (intake).

• There should be no more than 10 weeks between your first appointment (intake) and the start of the treatment.

• If a particular diagnosis has a longer than average waiting time, this must be indicated in advance.

“In practice, these deadlines are not always met,” says Aart Hendriks, professor of Health Law at Leiden University. “According to the Dutch Healthcare Authority, about 30 percent of patients had to wait longer.”

The insurer must mediate

In order to be eligible for the care to which you are entitled, it is possible to address your health insurer regarding its duty of care. It follows from this that they have to help with the mediation for a place. “Waiting persons can contact their insurer themselves,” says Tsui Ying Leung, spokesperson at the Dutch Healthcare Authority. “The insurer will then look for a faster place for the insured.”


Quote

Waiting list mediation can make a difference, but in practice this does not always work – also due to a shortage of care providers

Aart Hendriks

That is indeed possible, Hendriks agrees. The Health Insurance Act states that the health insurer must ensure that the insured receives care or services. The problem with this, according to the professor, is that it is assumed that policyholders are aware of this. “That’s probably not always the case. In those situations, the patient does not use waiting list mediation. It is possible that the GP will insist on emergency, but it is not known whether that will happen.”

Mention

Hendriks makes a small comment: “Waiting time mediation can make a difference, but in practice it does not always work – also due to the shortage of care providers.” More budget is needed to attract more healthcare staff. The good news is that it seems that this has been complied with in the care agreement.

In addition to contacting your health insurer, it can also help to visit the wegvandewachtlijst.nl site for tips and advice. Furthermore, MIND Kor Relatie offers one conversation and more if necessary. MIND Kor Relatie is a national organization where you can go for professional, psychological and psychosocial help. Do you have to wait longer than the treek standards allow and your health insurer cannot help you? Then you can report this to the Dutch Healthcare Authority.



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The article is in Dutch

Netherlands

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