When Equal Isn't Fair

The Netherland Healthcare System is a two-part system: private insurance for primary and curative care and social insurance for “long term” care. Their reform is based on the policy of risk sharing where the high cost of insuring the at-risk population is negated by the lower cost of insuring the healthier population. The universal coverage plan theoretically allows for risk equalization but the fact that there are multiple insurance companies prevents this from occurring since there won’t be an equal spread of high risk and low risk customers among each company.
In addition, the Dutch wanted to implement market-based competition for the private insurance, which is also funded through government subsidy and payroll taxes. The premise of such a system is to create competitive pricing for the consumer to choose from. The problem arises from the fact that the system is not sustainable. Since the government standardizes the basic plan, insurance companies must offer the plans at minimum profit for themselves to attract customers. This creates the possibility of the company not being able to stay in business since that’s what they are: corporations that put the dollar before the person. When companies go under, it’s feasible for patients to become lost in the shuffle or all together uninsured for a gap of time. What happens when they become ill during that transition phase without insurance? In my opinion, that is the scariest part of the Dutch insurance system.