title: [Better use of the front-end deductible in the Netherlands; private contributions to expenditure, costs awareness or incentives for quality].
abstract: One of the key items in the upcoming elections for the House of Representatives of the Netherlands is the continuation of the compulsory annual front-end deductible ("own risk") in health insurance. Getting rid of the deductible completely, as proposed by some parties, would create significant budget issues. This article suggests four alternatives. The first option is to abandon the yearly increase to help cover the overall growth in health care spending, and replace it with a maximum level for the deductible. The second is to convert it from a front-end to fixed, but capped co-payment every time care is consumed. The third option is to limit the deductible to out-of-network use of care. The final option is to abolish the deductible completely when a preferred provider is chosen.
authors.affiliation: Vrije Universiteit Amsterdam, Talma Instituut, sectie Gezondheidseconomie, Amsterdam.
authors.forename: E J E
authors.initials: EJ
authors.lastname: van der Hijden
mesh_terms: D003669:Deductibles and Coinsurance; D005102:Health Expenditures; D006801:Humans; D007348:Insurance, Health; D009042:Motivation; D009426:Netherlands