There are many different health care systems around the world. In the Netherlands medical treatment is accessible for everybody and I think this is a great asset. Our health care is funded partly by obligatory health insurance and partly by income related contribution. Key features are that the premium is not related to health status and the quality of care is not related to income. This seems ideal, but it has a downside. The costs of health care are rising and therefore the premium goes up every year. For example, this year the premium has gone up from 120 euro per month to 150 euro per month. If it goes on like this, many people will not be able to afford the obligatory health insurance.

New and advanced medical treatments are one of the reasons that health care is getting more expensive. In order to get a grip on those costs, Dutch insurance companies have put restrictions on the use of expensive treatments. These restrictions are based on medical grounds and not on financial ones.  One example is a new drug for diabetes that not only leads to better blood glucose levels but also to considerable weight loss. It has taken the drug companies many years to develop this drug and therefore it is quite expensive. One can imagine that obese patients with diabetes are eager to start with this new treatment but the insurance companies have decided that they only reimburse when people are morbid obese and conventional medication has failed. This system inevitably leads to more paperwork for health care providers and insurance companies and frustration for patients who do not get new treatments because they do not fit the criteria. Nevertheless, I think it is the only way that we can keep general health care affordable for all people and the best medicine available for those who need it most.