Web-economic-crisis-health-systems-and-health-web

266 Economic crisis, health systems and health in Europe: country experience
means that the municipalities have more policy discretion in shaping provision
of services formerly provided under the Exceptional Medical Expenses Act, as
long as they compensate citizens for their inability to participate in society.
For example, municipalities may choose to substitute professional care with
other solutions, such as care provided by neighbours or volunteers. The new
Act, containing only intensive long-term care for older people and people with
disabilities, will be called the Long-Term Care Act (Wet Langdurige Zorg) and
should come into force in 2015. Personal care (e.g. help with washing, dressing,
eating) will be removed from the entitlements under the Exceptional Medical
Expenses Act, with only nursing care and institutional care to be covered under
this Act. The exact content of the new Act is still subject to discussion (2014).
The government has succeeded in limiting the growth of its own contribution to
health care financing since the beginning of the crisis (Table 8.6). The decrease
in expenditure under the Exceptional Medical Expenses Act 2007 and 2008 can
be attributed to the transfer of home-help to the municipalities (see section 2.1
on Cost control). In the following years, a steady growth in expenditure under
the Exceptional Medical Expenses Act has been noted. The decrease in the
growth rate of expenditure covered under the Health Insurance Act (2009–
2011) can mainly be attributed to the lower expenditure on pharmaceuticals.
The growth in OOP expenditure can be attributed to the changes in the scope
and depth of coverage and the introduction (and subsequent increases) of the
compulsory deductible in 2008.
Table 8.6 Health care expenditure in the Netherlands, 2006–2011
Expenditure (€ million (% change))
2006 2007 2008 2009 2010 2011
Government 8,206
(n.a.)
10,724
(31%)
11,328
(6%)
12,390
(9%)
12,825
(4%)
12,915
(1%)
Exceptional Medical
Expenses Act
23,177
(n.a.)
23,007
(−1%)
22,169
(−4%)
23,201
(5%)
24,187
(4%)
25,263
(4%)
Health Insurance Act 26,727
(n.a.)
27,693
(4%)
32,325
(17%)
34,143
(6%)
35,623
(4%)
36,030
(1%)
VHI 2,904
(n.a.)
3,146
(8%)
3,154
(0%)
3,384
(7%)
3,429
(1%)
3,734
(9%)
OOP 6,896
(n.a.)
7,237
(5%)
7,913
(9%)
7,870
(1%)
8,075
(3%)
8,565
(6%)
Other 2,812
(n.a.)
2,837
(1%)
2,866
(1%)
2,913
(2%)
3,044
(4%)
2,874
(−6%)
Total 70,722
(n.a.)
74,644
(6%)
79,755
(7%)
83,901
(5%)
87,183
(4%)
89,381
(3%)
Source: Statistics Netherlands, 2013b.