Three coverage schemes provide broad health coverage to nearly all of the population of the Netherlands. These include a competitive social health insurance system for curative care, a single-payer system for long-term care and municipal systems for social care.
Like the rest of Europe, the Netherlands faced high pressures from the Covid-19 pandemic, and experienced a temporary drop in life expectancy in 2020. The unprecedented strain caused by Covid-19 posed a clear challenge at all levels of the Dutch health system.
The Netherlands’ health status
Life expectancy in the Netherlands is higher than the EU average by about one year, but gains have slowed over the past decade. As a result of the Covid-19 pandemic, life expectancy fell by 0.7 years between 2019 and 2020 – the same as the EU average. Lung cancer, stroke and ischaemic heart disease made up the highest share of mortality in 2019. In 2020, one in 15 deaths were attributed to Covid-19.
Risk factors
Behavioural risk factors in the Netherlands account for a lower share of deaths than the EU average. Smoking and obesity rates are both below the EU averages. However, one in five deaths in 2019 resulted from tobacco consumption – a higher share than in the EU – and obesity levels among adults have increased over the last two decades. Dutch adults and adolescents are more physically active than those in most other EU countries.
The Netherlands’ health system
The Netherlands spends more per capita (€3,967) on health than the EU average (€3,523), with a considerable share dedicated to long-term care. Expenditure on outpatient pharmaceuticals and medical devices is kept low, aided by volume and price control policies and well-established health technology assessment processes. Public sources cover a high percentage of health expenditure, resulting in a lower share of out-of-pocket spending for healthcare than the EU average.
Effectiveness
The Netherlands has among the lowest mortality rates from preventable and treatable causes in the EU. Most preventable deaths are from lung cancer, while colorectal cancer and breast cancer account for 40% of deaths from treatable causes. Mortality rates from ischaemic heart disease, stroke and pneumonia are among the lowest in the EU.
Accessibility
The Dutch population has historically reported low unmet needs for medical treatment, but this changed during the Covid-19 pandemic when many non-urgent services were cancelled or postponed. Evidence suggests that 15% of people had to forgo care during the first 12 months of the pandemic. Teleconsultations were used to help maintain access to services.
Resilience
The health system response to Covid-19 encountered obstacles, including fragmentation in testing, contact tracing and vaccination efforts. After a slow start, the vaccination campaign accelerated, and 63% of the population had received two doses (or equivalent) by the end of August 2021.
OECD/European Observatory on Health Systems and Policies (2021), The Netherlands: Country Health Profile 2021, State of Health in the EU, OECD Publishing, Paris/European Observatory on Health Systems and Policies, Brussels.
