Transcript Basis VWS NL

Long term care in the
Netherlands
Aloys Kersten
Dutch ministry of Health, Welfare and Sports
Barcelona, 14-10-2010
Outline
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Short movie
Dutch health care system
Organization of long term care
Developments in long term care
Future developments
Challenges
Health Care System
• Cure – Health Insurance Act
medical treatments
• Care – Exceptional Medical Expenses Act
• Support – Social Support Act
domestic support, special transportation,
home and living facilities
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Exceptional Medical Expenses Act : Functions
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Personal care
Nursing
Residence
Treatment (not medical)
Individual support
Exceptional Medical Expenses Act : Clients
• Elderly (dementia, physical problems)
• Handicapped (mentally, physically)
• Persons with psychiatric problems
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Exceptional Medical Expenses Act : Organization
• Need of an individual
• In contact with an intermediate organization
• Apply for help at the Central Indication
Bureau
• Zorgkantoor in each region
• Caretakers
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Exceptional Medical Expenses Act : Caretakers
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Private organizations without a profit goal
Target groups
Institutions vs home care
Big concerns vs individual carers
More than 600.000 employees
Exceptional Medical Expenses Act : Number of clients
Client
Dementia
Elderly with physical
problems
Handicapped
(mentally, physically)
Clients with
psychiatric problems
Total
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Institution
Home care
57.000
14.000
110.000
206.000
65.000
40.000
25.000
60.000
257.000
320.000
Exceptional Medical Expenses Act : Costs
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Exceptional Medical Expenses Act : Mantelzorg
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Exceptional Medical Expenses Act : Developments
• Started in 1968
55.000 clients
less than € 1 billion
• 2010
600.000 clients
€ 23,5 billion (= 5% of GDP)
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Exceptional Medical Expenses Act : Developments
• 1968: only uninsurable risks for a limited
group of people
• 2010: much more activities for a more
extensive group of people
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Exceptional Medical Expenses Act : Developments
• Last 10 years: Quality gap
• Single rooms in institutions
• Lack of social participation
• Need of client is leading
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Exceptional Medical Expenses Act : Developments
Handicapped
2000
2010
Number of
clients
103.000
Costs
€ 4,5 billion
(prices 2010)
105.000
(+ 2%)
€ 6,0 billion
(+ 33%)
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Exceptional Medical Expenses Act : Social Trends
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Ageing of Dutch population
Globalization
Regionalization
Individualisation
Technological developments
Financial tenability
Lack of staff
Exceptional Medical Expenses Act : Future developments
• New government, new plans
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Exceptional Medical Expenses Act : Future developments
• Main policies for the long term care
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Extra investment of € 1 billion
Assistance to the Social Support Act
Revalidation to the Health Insurance Act
Clients responsible for own housing
Competitive insurers
Exceptional Medical Expenses Act : Future developments
• Forecasts for 2015
• Costs from € 23,5 billion to € 28 billion
(+ 12%)
• Staff from 600.000 tot 680.000 employees
(+ 13%)
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Exceptional Medical Expenses Act : Challenges
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More innovations
Lesser rules (high trust – high penalty)
Investing in staff
Stimulating labour participation
Increasing self-sufficiency of care seekers