Going private? Statutory health insurance, sickness funds and the development of private health...
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Transcript of Going private? Statutory health insurance, sickness funds and the development of private health...
![Page 1: Going private? Statutory health insurance, sickness funds and the development of private health insurance in the Netherlands 1910-1986 R.A.A. Vonk Centre.](https://reader036.fdocuments.us/reader036/viewer/2022062409/5697bf7c1a28abf838c84432/html5/thumbnails/1.jpg)
Going private?
Statutory health insurance, sickness funds and the development of private health insurance in the Netherlands 1910-1986
R.A.A. Vonk
Centre for the history of health insurance, dept. Medical Humanities
![Page 2: Going private? Statutory health insurance, sickness funds and the development of private health insurance in the Netherlands 1910-1986 R.A.A. Vonk Centre.](https://reader036.fdocuments.us/reader036/viewer/2022062409/5697bf7c1a28abf838c84432/html5/thumbnails/2.jpg)
Centre for the history of health insurance, dept. Medical Humanities
![Page 3: Going private? Statutory health insurance, sickness funds and the development of private health insurance in the Netherlands 1910-1986 R.A.A. Vonk Centre.](https://reader036.fdocuments.us/reader036/viewer/2022062409/5697bf7c1a28abf838c84432/html5/thumbnails/3.jpg)
Centre for the history of health insurance, dept. Medical Humanities
- If and in what way sickness funds have influenced the private health insurance market during the period 1910 - 1986
![Page 4: Going private? Statutory health insurance, sickness funds and the development of private health insurance in the Netherlands 1910-1986 R.A.A. Vonk Centre.](https://reader036.fdocuments.us/reader036/viewer/2022062409/5697bf7c1a28abf838c84432/html5/thumbnails/4.jpg)
Centre for the history of health insurance, dept. Medical Humanities
1900
- Poor Law (no income)
- Sickness fund insurance (low income)
- Out of pocket payment (middle/high income)
![Page 5: Going private? Statutory health insurance, sickness funds and the development of private health insurance in the Netherlands 1910-1986 R.A.A. Vonk Centre.](https://reader036.fdocuments.us/reader036/viewer/2022062409/5697bf7c1a28abf838c84432/html5/thumbnails/5.jpg)
1910 – 1940
- ± 1910: private health insurers (comp. plans)
- 1912: binding resolution NMG
- 1910-1930: high failure rate and “malpractices”
- 1930: hospital plans
- Sickness funds as moral example
Centre for the history of health insurance, dept. Medical Humanities
![Page 6: Going private? Statutory health insurance, sickness funds and the development of private health insurance in the Netherlands 1910-1986 R.A.A. Vonk Centre.](https://reader036.fdocuments.us/reader036/viewer/2022062409/5697bf7c1a28abf838c84432/html5/thumbnails/6.jpg)
Centre for the history of health insurance, dept. Medical Humanities
![Page 7: Going private? Statutory health insurance, sickness funds and the development of private health insurance in the Netherlands 1910-1986 R.A.A. Vonk Centre.](https://reader036.fdocuments.us/reader036/viewer/2022062409/5697bf7c1a28abf838c84432/html5/thumbnails/7.jpg)
1941 – 1946
1941: Introduction of social health insurance
- compulsory (wage earners)
- voluntary (non wage earners)
- SHI schemes and PHI separated by an income limit
Centre for the history of health insurance, dept. Medical Humanities
![Page 8: Going private? Statutory health insurance, sickness funds and the development of private health insurance in the Netherlands 1910-1986 R.A.A. Vonk Centre.](https://reader036.fdocuments.us/reader036/viewer/2022062409/5697bf7c1a28abf838c84432/html5/thumbnails/8.jpg)
Sickness Fund Decree: repercussions
- PHI-companies lose major part portfolio
- Sickness funds start to offer suppl. insurance
- Sickness fund prohibited to provide PHI
Centre for the history of health insurance, dept. Medical Humanities
![Page 9: Going private? Statutory health insurance, sickness funds and the development of private health insurance in the Netherlands 1910-1986 R.A.A. Vonk Centre.](https://reader036.fdocuments.us/reader036/viewer/2022062409/5697bf7c1a28abf838c84432/html5/thumbnails/9.jpg)
1947-1969
- Expansion social health insurance (income limit)
- 1947: Bovenbouwers (PHI related to sickness funds)
- Sickness funds and private insurers against national
health insurance
- 1957: ANPZ-policy and VVBR risk-pool
Centre for the history of health insurance, dept. Medical Humanities
![Page 10: Going private? Statutory health insurance, sickness funds and the development of private health insurance in the Netherlands 1910-1986 R.A.A. Vonk Centre.](https://reader036.fdocuments.us/reader036/viewer/2022062409/5697bf7c1a28abf838c84432/html5/thumbnails/10.jpg)
1947-1969
- 1962: KLOZ (umbrella org. private health insurers)
- Plans to reform health care sector (BVV/AWZ)
- Bovenbouwers and insurers join forces
- 1967: NOZ risk-pool
Centre for the history of health insurance, dept. Medical Humanities
![Page 11: Going private? Statutory health insurance, sickness funds and the development of private health insurance in the Netherlands 1910-1986 R.A.A. Vonk Centre.](https://reader036.fdocuments.us/reader036/viewer/2022062409/5697bf7c1a28abf838c84432/html5/thumbnails/11.jpg)
Centre for the history of health insurance, dept. Medical Humanities
![Page 12: Going private? Statutory health insurance, sickness funds and the development of private health insurance in the Netherlands 1910-1986 R.A.A. Vonk Centre.](https://reader036.fdocuments.us/reader036/viewer/2022062409/5697bf7c1a28abf838c84432/html5/thumbnails/12.jpg)
1971-1980
- No immediate threat National Health Insurance
- Escalating risk segmentation / premium differentiation
- Skimming voluntary social health insurance
- Bovenbouwers apply entrepreneurial principles
Centre for the history of health insurance, dept. Medical Humanities
![Page 13: Going private? Statutory health insurance, sickness funds and the development of private health insurance in the Netherlands 1910-1986 R.A.A. Vonk Centre.](https://reader036.fdocuments.us/reader036/viewer/2022062409/5697bf7c1a28abf838c84432/html5/thumbnails/13.jpg)
1971-1985
- 1971: Zeven pijlers-plan
- 1974: Restructuring effort
- 1986: WTZ- Dissolving voluntary social health insurance
- Socializing private health insurance
- Standard policy
- Compulsory acceptance
- Fixed premium
Centre for the history of health insurance, dept. Medical Humanities
![Page 14: Going private? Statutory health insurance, sickness funds and the development of private health insurance in the Netherlands 1910-1986 R.A.A. Vonk Centre.](https://reader036.fdocuments.us/reader036/viewer/2022062409/5697bf7c1a28abf838c84432/html5/thumbnails/14.jpg)
Centre for the history of health insurance, dept. Medical Humanities
Conclusions
- Moral example
- “socialization” through competition (1960’s)
- SHI-principles enter PHI
- Failing self regulation (1970’s)
- PHI-principles enter SHI (bovenbouwers)
- Government intervention (1980’s)
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Thank you, for your attention