section_path: Demographics/Healthcare
section_name: Healthcare
paragraph_text: Healthcare
  
  In 2016, the Netherlands maintained its position at the top of the annual Euro Health Consumer Index (EHCI), which compares healthcare systems in Europe, scoring 916 of a maximum 1,000 points. The Netherlands has been among the top three countries in each report published since 2005. On 48 indicators such as patient rights and information, accessibility, prevention and outcomes, the Netherlands secured its top position among 37 European countries for six years in a row. The Netherlands was ranked first in a study in 2009 comparing the health care systems of the United States, Australia, Canada, Germany and New Zealand.
  
  According to the Health Consumer Powerhouse (HCP), patients have a great degree of freedom from where to buy their health insurance, to where they get their healthcare. Healthcare decisions are made in dialogue between patients and healthcare professionals. Healthcare in the Netherlands is split 3 ways: in somatic and mental health care and in 'cure' (short term) and 'care' (long term). Home doctors (huisartsen, comparable to general practitioners) form the largest part of the first level. Being referred by a member of the first level is mandatory for access to the second and third level. The health care system is in comparison to other Western countries, effective but not the most cost-effective. Healthcare is financed by a dual system that came into effect in January 2006. Long-term treatments, especially those that involve semi-permanent hospitalisation, and disability costs such as wheelchairs, are covered by a state-controlled mandatory insurance. In 2009 this insurance covered 27% of all health care expenses. Other sources of health care payment are taxes (14%), out of pocket payments (9%), additional optional health insurance packages (4%) and a range of other sources (4%). Health insurance in the Netherlands is mandatory. Healthcare in the Netherlands is covered by two statutory forms of insurance:
  
  While Dutch residents are automatically insured by the government for AWBZ, everyone has to buy their own basic healthcare insurance, except those under 18 who are automatically covered under their parents. Insurance companies are obliged to provide a package with a defined set of insured treatments. This insurance covers 41% of all health care expenses. Insurers have to offer a universal package for everyone over 18, regardless of age or state of health – it is illegal to refuse an application or impose special conditions. The funding burden for all short-term health care coverage is carried 50% by employers, 45% by the insured person and 5% by the government. Those on low incomes receive compensation to help them pay their insurance. Premiums paid by the insured are about €135 per month.