Healthcare appears to be the biggest victim of NATO’s promise to allocate billions extra for defense in the coming years. In other words: most parties finally dare to cut the health care costs that have been rising for years. This became apparent during the presentation on Friday calculation of the election manifestos by the Central Planning Bureau (CPB). “Many parties want to limit the growth of healthcare expenditure,” CPB director Pieter Hasekamp said in an explanation.
Healthcare is already stuck on all sides: there are waiting lists for mental health institutions, enormous growth in youth care, too few nursing home places, a large outflow of employees, a lot of absenteeism, major staff shortages. In the meantime, healthcare costs continue to rise every year due to the double aging of the population (there are more and more elderly people who are also getting older), high personnel costs and new treatment techniques and more expensive medicines. The Central Bureau of Statistics made announced last week that in 2024 an average of 8,610 euros was spent per Dutch person on healthcare and welfare (including, for example, youth care, childcare and asylum reception), 654 euros more than the previous year. The Department of Health, Welfare and Sport (VWS) has also had the highest or second-highest budget of all ministries for years, this year more than 110 billion euros.
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. The demand for personnel is increasing sharply, especially in elderly care – the peak of aging is between 2030 and 2040. That is unfeasible and unaffordable. Due to rising costs in the healthcare sector, VWS has had the largest or second-largest budget of all ministries for years.
Not popular
But for a long time, political parties hardly dared to touch it. Cutting back on healthcare is not a popular message, especially during election times. In fact, the Schoof cabinet proposed halving the deductible by 2027, a plan that costs billions extra annually.
Those times seem to be over. The new NATO standard of 3.5 percent of the gross domestic product, which the House of Representatives agreed to before the summer, will cost – increasing – 19 billion euros in 2035. The parties are looking for much of that money in healthcare. This is about ‘less more’: healthcare costs continue to rise, but less quickly than expected.
And that happens in many different areas. For example, the large halving of the deductible (from 385 to 165 euros) will almost certainly be reversed, although outgoing minister Jan Anthonie Bruijn (Healthcare, VVD) will soon send a proposal for this to the House of Representatives. Most parties want to keep the deductible at 385 euros (D66, SGP, NSC, ChristenUnie) or even increase it to 440 euros (VVD, CDA, JA21, Volt).
No return to nursing homes
But the parties want to make much more cuts in healthcare. For example, new treatments and medicines are no longer automatically included in the basic package (seven parties). No more money is being invested in improving the quality of nursing homes (six parties), and the personal contribution in those nursing homes can also be increased (also six). The plan to bring back old people’s homes is defeated by CDA, VVD, D66 and JA21.
All healthcare measures together should yield billions, with VVD and JA21 even almost 10 billion euros structurally. The parties barely mentioned their savings on healthcare when explaining their plans on Friday, after the CPB presentation. GroenLinks-PvdA, the only party that wants to invest more money in healthcare, made itself heard loudly. “The right wants to cut back on healthcare, increase the deductible and pass the bill to the poorest,” tweeted party leader Frans Timmermans. Jesse Klaver called the cuts on X “extremely unwise”. According to Jimmy Dijk (SP), “our welfare state is being converted into a war machine”, Geert Wilders (PVV) stated: “We would never divert billions for defense from healthcare!” It is unclear where SP and PVV want to make cuts and how they will work out; Both parties refused to have their programs calculated by the CPB.
Care more inaccessible
CPB director Hasekamp warned on Friday that the healthcare measures have major consequences in the longer term for the accessibility of care for lower incomes and the chronically ill. The quality of Dutch healthcare will also “in the long term lag somewhat behind the quality improvements in healthcare abroad.” According to the CPB, this leads to an increase in socio-economic differences: some people can purchase additional better care and support themselves, while the rest cannot.
One advantage for the parties that want to make cuts: healthcare was always among the three most important issues for voters when determining their vote. But coincidentally not (yet) in the coming elections, as emerged last week research from Ipsos. Migration, the housing market, norms and values, safety and the climate are all considered more important.
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Healthcare seems to be a taboo subject during election times
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