Managing costs and access to healthcare in the Netherlands: impact on primary care

Concerns about rising healthcare costs and the long term viability of healthcare in the Netherlands prompted the government to introduce statutory private health insurance in 2006. The move was accompanied by market mechanisms and competition between providers,1 2 based on the expectation that it would contain costs and improve quality ("the highest quality of care at the lowest price"). Additional policy measures were taken after 2006 to ensure that the healthcare system was able to deliver on these high expectations (table 1).3 We examine the effect of the changes on the population and the role of primary care.