10 billion euros. It is a historically high amount that the minority cabinet of D66, VVD and CDA wants to cut back on healthcare. “An Attack on Civilization,” responded SP faction leader Jimmy Dijk on X. “A cold cut and difficult to swallow,” wrote the FNV on its website.
In recent years, political parties have hardly dared to risk cuts in healthcare. That was not a popular message, so soon after the corona crisis and especially during election times. It is difficult for parties to explain who is and who is no longer entitled to certain care, or whether everyone has to pay more themselves. Cutback proposals always generate many angry letters and emails, and full public galleries during debates in the House of Representatives.
It was only during the election campaign last year that a change was seen. The calculations of the party programs by the Central Planning Bureau showed that all parties wanted to cut billions in healthcare – except for GroenLinks-PvdA, which wants to invest extra. Just like the PVV and the SP, but they never have their programs calculated and so it remains unclear where they want to make cuts.
It is not illogical that the taboo of cuts in healthcare now finally seems to be over. The minority cabinet needs billions for defense, among other things. They immediately looked at healthcare: the Ministry of Health, Welfare and Sport has the largest or second largest budget of all departments every year, in 2026 more than 114 billion euros – six percent more than in 2025.
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Put the brakes on the ever-rising healthcare costs
But under the guise of ‘finding extra money’, the minority cabinet can also tackle another major problem: the ever-rising healthcare costs. Due to the double aging of the population (there are more and more elderly people, who are also getting older), care is becoming unsustainable and unaffordable. Now there are about 1.6 million people over 75, in 2070 there will be 3.1 million, almost twice as many. The demand for care is increasing rapidly among people aged 75 and over. The costs of elderly care in 2040 will amount to approximately 37 billion euros. “Care for the elderly is in danger of becoming unaffordable,” top officials concluded in the 2023 report Doing nothing is not an option. At the same time, there are far too few people who can provide that care. One in seven workers currently works in healthcare, and by 2060 this should increase to one in three.
And so healthcare is at a standstill on all sides. Without intervention, according to the minority parties, healthcare is heading for a “healthcare infarction”, D66 leader Rob Jetten said during the presentation of the coalition agreement on Friday. “We spend less on it because we are fully convinced that if we don’t intervene, things will really go wrong.” He said he wanted to prevent “an explosion” in the health care budget. According to CDA leader Henri Bontenbal, the concern is “threateningto walk into a wall. If we do not address this, we will pass it on to the next generation.” In short: the demand for care must be reduced, and with it the costs. Although this is still a matter of ‘less-more’: healthcare costs will continue to rise, but less quickly.
Deductible cut into pieces
What cuts do the three parties want to implement? There are many, but a few stand out. Almost 6 billion euros, more than half, will be raised by reversing the (not yet introduced) halving of the deductible. The deductible – the amount that you must pay extra per year in healthcare costs from the basic package – will even increase, from 385 euros now to 460 euros from 2027. From that year onwards, the deductible will also be indexed annually. The amount has been ‘frozen’ since 2016 and has never been increased.
To compensate for the higher deductible, this is ‘cut into pieces’. Treatment in a hospital, for example, costs a maximum of 150 euros per time, so that a patient does not have to pay the entire deductible in one go. In addition, 350 million is made available annually for the chronically ill and disabled, who incur a lot of healthcare costs year in and year out. The idea behind the deductible is that policyholders think carefully about whether they really need care. It slows down demand.
But the minority cabinet has much more planned. This is how the knife goes in the basic package. Medicines that can be purchased without a prescription at a pharmacy, drugstore or supermarket are removed from the package and are therefore no longer reimbursed. There is a closer look at whether expensive medicines and specialist medical care belong in the package. The mandatory reimbursement of uncontracted care (care from a provider with whom your health insurer does not have a contract, which means you receive a lower reimbursement) will disappear from 2029. The underlying idea here is also that unnecessary care is prevented and people are more aware of their use of care.
Hundreds of millions less will soon be spent on long-term care (elderly care, care for the disabled, mental health care), partly by allowing people to live at home longer. That should save one billion euros from 2031. People who can do this will from now on pay for their domestic help themselves, and there will also be a personal contribution to community nursing. The deduction for specific healthcare costs and the allowance for specific healthcare costs (a deduction for income tax) will be completely abolished.
During their presentation, the three parties spoke about “major breakthroughs” and “necessary reforms”. Remarkably, they not only received negative reactions from the healthcare field, but also support. ActiZ, the trade association of about 350 healthcare organizations, says it “recognizes the need for change in elderly care.” Health economists have also been calling for a change for some time. For example, health economist and former CPB member Marcel Canoy read the coalition agreement as “a reform agenda that is desperately needed in the context of waste, aging and a tight labor market.” he wrote on LinkedIn.
In the coalition agreement, the parties write several times that they want to invest in ‘caring neighborhoods’, something Canoy has also been advocating for years. In essence, that term means that society must do more. Problems that do not belong in healthcare but where people do go to the doctor, for example – such as loneliness – must be solved by society itself. Older, still healthy informal caregivers and volunteers can, for example, drink a cup of coffee with someone, go shopping or help the elderly in another way. In this way, the scarce healthcare staff must be protected and healthcare costs can be controlled.
There seems to be increasing support for that idea, including politically. In 2023, Canoy already presented a manifesto to the then cabinet and House of Representatives to support these caring neighborhoods – which then became signed by dozens of people from, among others, the healthcare sector and GroenLinks MP Corinne Ellemeet. Former VVD State Secretary Vincent Karremans also made a similar call in an interview in NRC in 2024. He wanted society to help children more, to relieve the burden on the overburdened youth care system.
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