Long term care in the Netherlands Aloys Kersten Dutch ministry of Health, Welfare and Sports...
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Transcript of Long term care in the Netherlands Aloys Kersten Dutch ministry of Health, Welfare and Sports...
Long term care in theNetherlands
Aloys KerstenDutch ministry of Health, Welfare and Sports
Barcelona, 14-10-2010
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Outline
• Short movie
• Dutch health care system
• Organization of long term care
• Developments in long term care
• Future developments
• Challenges
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Health Care System
• Cure – Health Insurance Actmedical treatments
• Care – Exceptional Medical Expenses Act
• Support – Social Support Actdomestic support, special transportation, home and living facilities
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Exceptional Medical Expenses Act : Functions
• Personal care
• Nursing
• Residence
• Treatment (not medical)
• Individual support
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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
• Private organizations without a profit goal
• Target groups
• Institutions vs home care
• Big concerns vs individual carers
• More than 600.000 employees
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Exceptional Medical Expenses Act : Number of clients
Client Institution Home care
Dementia 57.000 14.000
Elderly with physical problems
110.000 206.000
Handicapped
(mentally, physically)
65.000 40.000
Clients with psychiatric problems
25.000 60.000
Total 257.000 320.000
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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
103.000 105.000
(+ 2%)
Costs € 4,5 billion
(prices 2010)
€ 6,0 billion
(+ 33%)
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Exceptional Medical Expenses Act : Social Trends
• Ageing of Dutch population
• Globalization
• Regionalization
• Individualisation
• Technological developments
• Financial tenability
• Lack of staff
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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
• Extra investment of € 1 billion
• Assistance to the Social Support Act
• Revalidation to the Health Insurance Act
• Clients responsible for own housing
• Competitive insurers
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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
• More innovations
• Lesser rules (high trust – high penalty)
• Investing in staff
• Stimulating labour participation
• Increasing self-sufficiency of care seekers