Health insurance package management less effective at controlling expenditure than envisaged

Systematic review of basic health insurance package provides opportunities for improvement

The removal of certain treatments from the basic health care insurance package has so far proved less effective at controlling health care expenditure than intended. The Minister of Health, Welfare and Sport (VWS) has saved an estimated €0.25 billion in health expenditure by using this instrument, while a saving of €0.5 billion had been expected. An example of the savings is to no longer reimburse the cost of medicines to reduce blood cholesterol. The Minister of VWS had expected this measure to save €97 million a year, in reality it cut expenditure by just €18 million a year. The Dutch National Health Care Institute is currently systematically reviewing the basic health insurance package to identify inefficient treatments. In the Court of Audit’s opinion this approach in combination with the promotion of ‘appropriate provision’ (providing no more and no less care than necessary) offers promising opportunities to increase the effectiveness of package management. These findings are presented in a report the Court of Audit issued on 28 April 2015 entitled Basic health insurance package; Expenditure management in the health care sector part 3.