What are the plans in healthcare for the next four years? This is currently being agreed between the government and 17 healthcare organizations. The concept on the table for this (the Integral Care Agreement concept) has been leaked. What does it say, and what does that mean for seniors?
Less growth in healthcare costs
One of the tasks for the agreement was to curb the growth of health care expenditure with 1.3 billion euros. Even with this brake, healthcare costs still rise, so it is not a real ‘cutback’. But it does mean that health care premiums rise less rapidly.
Less budget for GP and district nurse
De Volkskrant reported on the front page: district nursing will receive 600 million euros less over the next four years, on a budget of 3.8 billion. The GP will receive 80 million euros less. To be clear: it is not about the current incomes of general practitioners and nurses. These amounts are ‘on the shelf’ and we would be better off spending on something else, according to the ministry. But it is remarkable that GPs and district nurses in particular no longer receive these amounts in advance, while the work pressure is so high for them. Also because they have an important task: to ensure that people can live at home longer and have to go to the (expensive) hospital less often. That is why not only the general practitioners and nurses, but also the Senior Coalition (ANBO, KBO-PCOB, Koepel Gepensionelingen and NOOM) are critical of the plan.
Contact the region for care
The agreement also includes the plan to divide the Netherlands into 31 regions. Within that region, all primary care providers (such as the general practitioner, district nurse, physiotherapist, psychologist, social worker, etc.) will work better together. The intention is for health insurers and municipalities to conclude major contracts with these partnerships. The idea is that everyone who needs it will have care nearby, which will be reimbursed.
Free choice of doctor now costs more money
At the moment everyone can choose which doctor or healthcare provider they want. The insurer is obliged by the health insurance law to reimburse a large part of this care, also with a cheap budget insurance or in-kind insurance. This proposal puts a line through this. This is called abolishing the ‘free choice of doctors’. Because in fact it means that you have to pay more (or everything) if you have cheap health insurance and you want to choose your own healthcare provider. It is not yet known how much you have to pay. Only the reimbursement policy reimburses all costs, whichever care provider you choose, but that also has a higher premium. Especially among psychologists and district nurses there are care providers who deliberately do not conclude a contract with the health insurer, Zembla showed in a broadcast.
Care through the computer
Primary care with general practitioners, district nurses and some of the mental health and social workers is overflowing. The computer has to step in, according to the proposal. Minister Ernst Kuipers had also already put data exchange and digitization on the agenda for this agreement. The computer will therefore play a greater role in healthcare, although it is not yet known what that will look like.
Travel to a specialized hospital
For common procedures, such as cataract surgery or a new hip, you can simply go to the hospital nearby. But for more complicated care such as specialized surgery for prostate cancer, it is better to go to a specialized hospital, according to the agreement. Those hospitals must treat a minimum number of specific patients each year in order to maintain their quality. That was already the case, but these rules are becoming stricter.
Help with healthier living
From 2025, all patients will be offered a lifestyle program by their healthcare provider. What and how is not yet known.
Ambulance no longer in hospital within 45 minutes
Now ambulances have to comply with the law to be able to take someone to the hospital within 45 minutes. That requirement is at odds with the agreement. That is perfectly possible, according to a recommendation by the Health Council.
What now?
The care agreement would be presented on Prinsjesdag on 20 September. Then we know which plans go through and which don’t.
Sources: Zorgvisie, Volkskrant Medical Contact, central government, LHV, Financial newspaper, Skipr
