Spending on Health Care in the Netherlands: Not Going So Dutch

Tinbergen Institute Discussion Paper 16-024/V

43 Pages Posted: 10 Apr 2016

See all articles by Pieter Bakx

Pieter Bakx

Erasmus University Rotterdam (EUR)

Owen O'Donnell

Erasmus University Rotterdam (EUR) - Erasmus School of Economics (ESE)

Eddy van Doorslaer

Erasmus School of Economics

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Date Written: April 8, 2016

Abstract

The Netherlands is among the top spenders on health in the OECD. We document the life-cycle profile, concentration and persistence of this expenditure using claims data covering both curative and long-term care expenses for the full Dutch population. Spending on health care is strongly concentrated: the one per cent of individuals with the highest levels of expenditure account for one quarter of the aggregate in any one year. Averaged over three years, the top one per cent still accounts for more than a fifth of the total, indicating a very high degree of persistence in the largest expenses. Spending on long-term care, which amounts to one third of all expenditure on health care, is even more concentrated: the top one per cent accounts for more than half of total spending on this type of care. Average expenditure rises steeply with age and even more so with proximity to death. Spending on individuals in their last year of life absorbs one tenth of aggregate health care expenditure. In a given year, spending on health care is highly skewed toward individuals with lower incomes. Average expenditure on the poorest fifth is more than three times that on the richest fifth. Spending on long-term care is five times more concentrated on the poor.

Keywords: Health expenditure, Long-term care, Social insurance, the Netherlands

JEL Classification: D12, I13, I14

Suggested Citation

Bakx, Pieter and O'Donnell, Owen and van Doorslaer, Eddy, Spending on Health Care in the Netherlands: Not Going So Dutch (April 8, 2016). Tinbergen Institute Discussion Paper 16-024/V, Available at SSRN: https://ssrn.com/abstract=2760794 or http://dx.doi.org/10.2139/ssrn.2760794

Pieter Bakx (Contact Author)

Erasmus University Rotterdam (EUR) ( email )

Zuid-Holland
Netherlands

Owen O'Donnell

Erasmus University Rotterdam (EUR) - Erasmus School of Economics (ESE) ( email )

P.O. Box 1738
3000 DR Rotterdam, NL 3062 PA
Netherlands

Eddy Van Doorslaer

Erasmus School of Economics ( email )

Netherlands

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