Health insurance reform in the Netherlands: assessing the progressivity consequences

Abstract

This paper examines the effects of the proposed Health Insurance Reform in The Netherlands on the incidence of the burden of health care finance. The focus of attention is on the measurement of the degree of progressivity of health care payments with respect to income. By means of an empirical simulation, we have examined how the regressiveness of the Dutch health care financing system would have been affected if the proposed health insurance reform had already been implemented in 1987. The regressiveness of the simulated distribution under various assumptions is then compared to the actual distribution of health care payments across income deciles in 1987. Since concern about the solidarity between publicly and privately insured in the current system was one of the prime motivations for proposing the reform, information on the likely distributional effects is highly relevant from a policy perspective.