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Related Experiment Videos

The basic benefit package: composition and exceptions to the rules. A case study.

Madelon Kroneman1, Judith D de Jong1

  • 1NIVEL (Netherlands Institute of Health Services Research), PO box 1568, 3500 BN Utrecht, The Netherlands.

Health Policy (Amsterdam, Netherlands)
|February 15, 2015
PubMed
Summary
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The Dutch Health Insurance Act

Area of Science:

  • Health Policy
  • Health Economics

Background:

  • The Dutch Health Insurance Act of 2006 mandated a universal basic benefit package.
  • This package undergoes annual review and adjustments due to rising costs, innovations, and economic factors.

Purpose of the Study:

  • To analyze the decision-making criteria for the Dutch basic health insurance package since 2006.
  • To investigate deviations from established criteria and their impact, including the 'yo-yo effect'.

Main Methods:

  • Review of official decision-making processes for the basic benefit package.
  • Analysis of specific case studies demonstrating deviations from stated criteria.

Main Results:

  • The annual assessment of the basic benefit package is influenced by factors beyond stated criteria.
Keywords:
Basic benefits packageHealth insuranceHealth systems reformPolicy development.

Related Experiment Videos

  • Political and interest group pressures can lead to the inclusion or delayed exclusion of treatments.
  • Organizational reforms, such as in mental healthcare, can cause seemingly inconsistent package changes.

    • Conclusions:

    • The criteria for the basic benefit package are open to broad interpretation.
    • External influences, including political and lobbying efforts, significantly impact inclusion/exclusion decisions.
    • The 'yo-yo effect' of certain treatments/pharmaceuticals negatively affects stakeholders.