| The Netherlands is a relatively small country in the northwest of Europe. With a population of a little below 17 million, the Netherlands has the highest population density of the EU countries after Malta. The country is divided into twelve administrative provinces, which are further parted into 430 municipalities. The Netherlands also encompasses three Caribbean islands, which are considered special municipalities. Dutch healthcare financing underwent a large reform in 2006 with the intent to improve competition and efficiency. The system is now financed by a two-sided insurance system; long-terms hospital care and disability costs are financed by state-controlled obligatory insurance, whereas short term medical services are covered through mandatory private insurance within a state controlled market. Within this system, insurance companies are not allowed to discriminate according to age and disability, and the content of the insurance package is fixed. Employers pay up to 50% of the premiums, and disadvantaged citizens receive state subsidies.
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| The issue of health inequalities has been present on the Dutch political agenda since the end of the 1980s thanks to the construction of two investigative commissions initiated by the Ministry of Health as a part of the Program Committee on Socioeconomic Health Differences. The task of the two bodies was to examine the nature and scope of health inequalities in the Netherlands. Since then, the issue of health inequalities has been integrated into the overall health strategy. A particular feature of the situation in the Netherlands is a national strategy with the aim to reduce health inequalities in large cities. The main target of this policy is to bridge the health gaps in terms of average life expectancy and avoidable inequalities.
National funds are available for the implementation of projects aimed at the reduction of health inequalities as well as research in that area (Public Health Fund and Healthy Living Programme). The National Institute for Public Health and Environment (RIVM) is responsible for monitoring the progress of achievement of the target to extending healthy life expectancy of the lower income groups by 25% of the current difference (3 years) by 2020. The first results of the monitoring exercise will be known in 2006. An overview of policy responses addressing health inequalities in can be found in our Policy Database. |
The Netherlands
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