The Affordable Care Act established private health insurance exchanges in the United States. The Dutch purchase healthcare from a similar exchange with similar regulations. Americans should analyze the Dutch healthcare system and determine how they are different and where they have succeeded. Here are three interesting ways healthcare in the Netherlands is different than healthcare in the US:
- The Dutch employ fewer pharmacists. 26 pharmacists were professionally active in the Netherlands for every 100,000 citizens in 2011 versus 87 pharmacists in the United States. The Dutch employ pharmacy assistants who are required to complete three years of vocational education. Pharmacy assistants have more responsibility than pharmacy technicians in the United States and allow Dutch retail pharmacies to fill 500 prescriptions per day with fewer than two FTE pharmacists.
- Companies must submit cost-effectiveness analyses with new drugs to allow the Dutch Health Care Insurance Board to determine reimbursement. This policy took effect at the beginning of 2005. Initial submissions were criticized for their quality, but submissions receiving reimbursement were determined to be methodologically sound at a greater rate than submissions that did not receive reimbursement.
- The Dutch spend less on their medications. The Netherlands spent 1% of its GDP on pharmaceuticals in 2013 versus 2% of GDP by the United States. Pharmaceutical expenditure fell in both countries from 2009-2012 but fell at a greater rate in the Netherlands. The Dutch spend on healthcare at a rate that is 70% of ours (% GDP/%GDP), yet spend on pharmaceuticals at a rate that is 50% of ours.