Dutch health insurance costing 23.5% of income

Costs rising in universal health insurance scheme similar to that proposed in Ireland

White Paper says universal health insurance will not be more expensive than two-tier system it is due to replace in 2019. Photograph: Andrew Matthews/PA Wire
White Paper says universal health insurance will not be more expensive than two-tier system it is due to replace in 2019. Photograph: Andrew Matthews/PA Wire


Families in the Netherlands, which has a system of universal health insurance similar to the one Minister for Health James Reilly wants to introduce in Ireland, are paying up to a quarter of their income on healthcare, according to a report.

A family with a combined income of under €50,000 a year was paying almost €11,500 in health costs in 2012, or 23.5 per cent of income, according to the analysis by the Dutch Health Performance Report for its government. Almost €6,000 of this was for health insurance premiums while the remaining €5,000 related to exceptional medical expenses.


Gross income
Michael van den Berg, one of the authors of the report, said the figure related to gross income and included premiums and taxes but not out of pocket payments. When these were included, for example for dental care and over-the-counter medicines, the total figure would be slightly higher.

The Government last week published its White Paper on universal health insurance (UHI), which is largely though not exclusively based on the Dutch model. Dr Reilly promised “everyone will be a winner” under the system, but critics claim it will be prohibitively expensive.

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The White Paper says the new system will not be more expensive than the two-tier system it is due to replace in 2019. It say it isn’t possible to say what average premiums would be now, but suggests they would be lower than the average €920 paid by individuals in private health insurance premiums last year. However, the Department of Public Enterprise has suggested premiums could be more than €1,600 a year.


Costs rising
The health system in the Netherlands is highly regarded but, as everywhere, costs have been rising steeply. Health spending doubled in the last 11 years, from €47 billion in 2000 to €90 billion in 2011, according to the report.

The Irish College of General Practitioners has said research shows insurance-based systems are more expensive than tax-based systems as well as more expensive for individuals.

Paul Cullen

Paul Cullen

Paul Cullen is a former heath editor of The Irish Times.