Overview

The Netherlands has a decentralized health system with private insurers and private providers. Nearly all (99.9%) of the Dutch population has access to a wide range of services with an emphasis on primary health care supported by a GP gatekeeper system. The Netherlands spent US$ 7 179 per person on health care in 2021, 85% of which was funded by public sources. Out-of-pocket (OOP) spending in the Netherlands accounted for 9.3% of total health expenditure in 2021, roughly two-thirds of the EU average. Most OOP spending went towards cost-sharing for inpatient and outpatient services or pharmaceuticals. In 2021, the largest share of health expenditure went to long-term care at 27.7%, the highest in the EU (average: 16.0%), followed by outpatient care (24.7%), which is also higher than the EU average (22.7%).  The Netherlands has a smaller physical infrastructure but more nurses than most EU countries.

The Dutch health system is pursuing reforms that improve accessibility and coverage, especially in the mental health and long-term care systems. These include a shift away from specialized care as well as a growing emphasis on care integration, often linked to financing. Additionally, sectoral agreements were introduced to control health care expenditure in 2012, targeting financial and care-related matters in various sectors; in 2022–23, a new cross-sectoral Integrated Care Agreement (Integraal Zorg Akkoord; IZA) was reached involving stakeholders from the care and social sectors. Future reforms are expected to address workforce shortages, dental care coverage, care quality, and the health system's financial sustainability and resilience.