Dutch health care system embraces private insurance, outperforms Canadian system

CALGARY--Despite similar costs, the Dutch health care system features shorter wait times than the Canadian system with similar to superior outcomes, finds a new study released today by the Fraser Institute, an independent, non-partisan Canadian public policy think-tank.

The study, part of a series of Fraser Institute studies examining health care policies in other countries, spotlights the health care system in the Netherlands. "The Dutch health care system offers more timely access to emergency care, primary care, specialist care and elective surgery than the Canadian system, with wait times in the Netherlands having shortened significantly in recent years. Policymakers interested in reducing delays for health care in Canada could learn valuable lessons from the Dutch approach," said Nadeem Esmail, Fraser Institute senior fellow and author of Health Care Lessons from the Netherlands. Both the Canadian and Dutch health care systems are relatively expensive in comparison with universal access systems in other developed nations. In 2009, Canada had the most expensive universal system, followed by the Netherlands. Canadian health care spending was two per cent higher than in the Netherlands, and 26 per cent higher than in the average developed universal access country. So what lessons can be learned from the Dutch approach?

---

The study notes that rather than relying on a Canadian-style tax-funded monopoly government insurer, the Dutch system provides universal coverage in an insurance premium-funded system with competition among private (both for-profit and not-for-profit) insurers. "Dutch insurers compete with one another for subscribers in part by providing services that reduce wait times, with some insurers guaranteeing some treatments in as little as five working days," Esmail said. Among hospitals and surgical clinics, the private sector also plays a dominant role. In 2010, the Netherlands had 151 hospitals and 52 outpatient specialty clinics, operated by 93 organizations. Eight of these organizations were university medical centres, the rest were private not-for-profit corporations competing in the marketplace. Additionally, 150 independent treatment centres (both for-profit and not-for-profit) provided same-day elective services such as orthopedic surgeries and ophthalmological treatments. Though government plays an important role in funding, regulation and oversight, the operation of health care in the Netherlands is left largely to private insurers and providers. "Expanding the role of the private sector in the delivery of hospital and surgical services, and transitioning to a system of independent competitive insurers, would improve both the quality and timeliness of health care for Canadians," Esmail said. MEDIA CONTACT: Nadeem Esmail, Director of Health Policy Studies, Fraser Institute, nadeem.esmail@fraserinstitute.org, @NadeemEsmail