Dutch public health and health care anno 2010: take a course for the future

Abstract

The Dutch debate on the future of public health and health care at the moment is colored by the forthcoming parliamentary elections in June. New government papers came forward with proposals aiming at a 20% reduction in all collective expenses. Dutch health care seems at a cross road of choices between more free market and more government influence to constrain rising costs. It is a lucky coincidence that just now three reports are published that give facts and figures on long term trends that can guide the election and decision process: the four-yearly Public Health Forecast 2010, the two-yearly Health Care Performance Report and the yearly State of Health Care Report, this time devoted to the effectiveness of municipal health promotion policy. In this opinion part of our Journal the head findings are described by the authors of the three reports. They point out a number of positive and negative highlights: an unexpected sharp rise in life expectancy, unchanged big socioeconomic health differences, limited effectiveness of health promotion and fast rising health care costs and use of health care in the Netherlands. Six short papers present comments on the reports. Commentators are respectively working at the Ministry of health, university of Rotterdam, a health insurance company, the association of municipalities, and a general practitioner.

With contributions of Van der Lucht and Polder, Van Wijngaarden and Reulings, Westert, Huijts and Van Halder, Van der Grinten, Kager, Korthuis, Donker, and Zaat.