Healthcare must change, say the major health insurers. According to Joep de Groot, chairman of the board of health insurer CZ, healthcare will not remain accessible to everyone in this way in the future. The biggest problem: the imbalance between supply and demand. The demand for care continues to rise, while the number of employees does not increase. There are already about 49,000 healthcare workers too few, according to an analysis by ABF Research at the beginning of this year. De Groot: “We must therefore provide more care with the same number of people.”
Health insurers had to announce their new premiums by this Saturday at the latest. CZ increases the most frequently used premium by EUR 3.75 per month, Zilveren Kruis by EUR 7.50, Menzis by EUR 8 and VGZ by EUR 9.30. The smaller health insurer DSW already announced the premium increase at the end of last month, traditionally a week after Prinsjesdag: 9.75 euros per month. These are significant increases, although the expectation was even greater: with Budget Day, the government predicted an average increase of approximately 11 euros per month.
Health insurers are legally obliged to maintain financial reserves in order to be able to absorb unforeseen setbacks. If there are more reserves than required, they can partly be used to lower the premium or increase it less rapidly. For example, CZ will contribute 110 million euros this year and Menzis 50 million euros. For both CZ and Menzis this means that they limit the increase in the standard premium by approximately 3 euros: otherwise it would increase by 6.75 euros and 11 euros per month respectively.
Also read: Significantly higher health care premiums, but it could have been worse
Zilveren Kruis cannot yet say whether it will use reserves. VGZ does not do this, because otherwise it will not have enough left over for setbacks. A spokesperson for VGZ cites inflation and disappointing stock prices as examples of real risks for which reserves must be maintained.
Appropriate care
The biggest drivers of rising premiums are higher personnel costs, inflation (including rising energy prices) and an aging population. De Groot of CZ: “The salary increases in healthcare are justified. At the same time, we see that people have difficulty paying the health care premium.” The premium increases are a warning: healthcare must be organized differently, say all four major insurers in their press releases.
Sometimes we provide care that makes you wonder whether we should do it
According to De Groot, it is necessary to think about ‘what really is care’. “Sometimes we provide care that makes you wonder whether we should.” De Groot mentions ‘shop windows’ as an example, a condition that causes pain when walking. “That is often standard surgery, while you can also start with gait training,” he says. “That kind of less appropriate care has to be removed in order to be able to meet the growing demand.” At the same time, says De Groot, it must be guaranteed that vulnerable patients can continue to receive the necessary care. “It’s going to be an exciting time.”
Georgette Fijnman, chairman of the board of Zilveren Kruis, also emphasizes the importance of appropriate care. “We are a health insurer, not a doctor, so it is difficult to say exactly what is and is not necessary. But we have to make informed choices about that together. Are we sending people to the hospital too soon? Are we performing treatments that are not always necessary?”
Bone fracture app
The health insurers are also arguing for more digitization. “Chronic care in particular lends itself well to this,” says De Groot. According to him, it is not always necessary for the chronically ill to come to the doctor ‘in a certain rhythm’, and they can do more themselves, such as keeping values in an app. “In this way, unnecessary consultations can be skipped. A healthcare provider will only intervene if there is a medical necessity.” He acknowledges that patients often enjoy the routine checkups, but, he says, “we just don’t have the resources anymore.”
Also read: In the new care agreement, sick people will more often have to rely on themselves
Fijnman van Zilveren Kruis mentions the Virtual Fracture Care app as an example of appropriate and more digital care. This means that patients no longer have to go to the hospital for a follow-up check after a simple bone fracture: they receive all the information to recover at home in an app. “This way fewer people come to the hospital who don’t necessarily have to be there.”
Digitization and appropriate care are themes that also recur in the Integral Healthcare Agreement, in which the Ministry of Health establishes agreements with the most important healthcare parties for the next four years. But doesn’t digitization take a piece of humanity out of healthcare? In any case, Fijnman is not afraid of that. “We have to preserve humanity where it is needed. It is important that the patient keeps the choice for personal contact. But doing everything digitally that can be done digitally saves time that we desperately need.” It therefore seems inevitable that personal contact will have to be sacrificed in order to compensate for the large staff shortage in the care sector.