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In Netherlands, Insurers Compete Over Quality of Care

In the first of a series on health care abroad, Ray Suarez looks at how the Netherlands achieved a massive health care overhaul four years ago.

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  • JIM LEHRER:

    Next tonight, our global health unit begins a series of reports on the ways other countries are delivering health care. Ray Suarez has the first of two stories on the Netherlands, where the government recently shook up health care.

  • RAY SUAREZ:

    Every September, Queen Beatrix of the Netherlands travels in a gilded coach from her palace to the Dutch parliament a few blocks away. The streets of the capital are packed with her subjects, dressed to honor the country's royal House of Orange.

    By world standards, the Dutch are wealthy and healthy, but the country's changing. With each year, it's home to more Dutch elderly and more young immigrants from the developing world.

    The queen opened a parliament once again wrestling over health care, still trying to contain costs after a massive overhaul designed four years ago.

    Abraham Klink is the Dutch minister of health.

    DR. ABRAHAM KLINK, minister of health, Netherlands: Health care had to be accessible and affordable to everyone, but on the other hand, there had to be competition. What we did the last years is to make — to create an infrastructure in which the insurance companies can make a difference and make a difference on the side of quality and the side of prices.

  • RAY SUAREZ:

    What the Netherlands did is require everyone to buy health insurance and hand over what was a system of public-private health care coverage to private insurance companies.

    When the Netherlands redesigned its national health care system in 2006, there were three main goals: continue universal coverage, unleash competition between private insurers, and keep down costs for the long run.

    Every citizen is required to buy a basic package that typically costs about $160 a month. The insurance companies are required to offer the same prices to all customers, regardless of age or medical history. Low-income residents have their premiums subsidized. Health care shoppers can choose to pay more for coverage, for things like dentistry, cosmetic surgery, or physiotherapy.

  • RINA NOPPEN:

    You always can choose for a basic health care, and one star, two star, three stars, four stars. If you choose for four stars, everything is…

  • RAY SUAREZ:

    Covered?

  • RINA NOPPEN:

    Everything's covered.