This presentation gives a brief insight in the current healthcare system in the Netherlands. This presentation was given in Praha

1. Healthcare in the Netherlands Focussed on hospitals Prague, 25 November 2009

2. Agenda Introduction Financing health care in the Netherlands Critical succesfactors for implementing a new system Lessons learned Trends and future developments Questions and discussion

3. Introduction - Current health care costs How to control health care expenditure in coming years? 13,3% 13,1% 13,1% % GDP in the Netherlands PM 6,3% 6,6% % GDP in The Czech Republic Total health care costs in the Netherlands * = preliminary figures 5,8% 4.809 4.545 4.315 Per person (in Euros) 6,2% 79.091 74.446 70.533 Total 0,4% 2.505 2.494 2.327 Administrative 5,7% 30.204 28.562 27.523 Cure 6,9% 46.382 43.390 40.683 Care ∆ 07/08 2008* 2007* 2006 in millions of Euros

6. Financing health care in the Netherlands – in general – Health Care providers Health care insurers Risk Equalisation Government Policyholders Hospitals Etc. Employers Contribution Contribution Fees Premiums Personal contributions Tax Allowances Cure Settlements Government compensates for budget overruns

7. Financing health care in the Netherlands – hospitals Registration of primary activities and insight into cost prices of products are essential Financing guaranteed by the government Market prices negotiated with health insurance companies Budget based Based on market prices 2004 2020 2012 Parameters related to medical activities Parameters (30,000) based on fee for service model Parameters (3,000) based on fee for service model

11. Trends and future developments – Measuring Quality – Distribution of hospitals in terms of ‘quality of care’. The blue mark indicates the percentage of hospitals performing less good than hospital X

12. University General practitioners Personal health care Elective non-complex care Specialized clinics Process oriented Market prices Basic hospital care Rural hospitals Compliants oriented Performance-related funding Elective very complex care University Medical Centers and large hospitals Process oriented Licensed care and prices Top preference care University Medical Centers Disease oriented Performance-related funding and an academic surcharge Complexity Plan eligibility Trends and future developments – Financing hospitals –

14. Questions and discussion