Healthcare in the Netherlands
A 2008 article in the journal "Health Affairs" suggested that the Dutch health system, which combines mandatory universal coverage with competing private health plans, could serve as a model for reform in the US. However,
an assessment of the 2006 Dutch health insurance reforms published in Duke University's "Journal of Health Politics, Policy and Law" in 2008 raised concerns. The analysis found that market-based competition in healthcare may not have the advantages over more publicly based single payer models that were originally envisioned for the reforms:
Buurtzorg Nederland
Buurtzorg Nederland is a Dutch home-care organization which has attracted international attention for its innovative use of independent nurse teams in delivering high-quality, relatively low-cost care. Buurtzorg is Dutch for “neighborhood care”.
It was founded in 2006 in the small city of Almelo by Jos de Blok and a small team of professional nurses who were dissatisfied with the delivery of health care by traditional home care organizations in the Netherlands. According to Sharda S. Nandram, the company has created a new management approach: “integrating simplification,” characterized by a simple, flat organizational structure through which a wide range of services, facilitated by information technology, can be provided.
When they go into a patient’s home, Buurtzorg’s nurses provide not only medical services but also many support services, such as dressing and bathing, that are usually delegated to lesser-trained and cheaper personnel. Self-governing teams of 10 to 12 highly trained nurses take responsibility for the home care of 50 to 60 patients in a given neighbourhood. This permits flexibility in work arrangements to meet both nurses’ and patients’ needs. The organization has the most satisfied workforce of any Dutch company with more than 1,000 employees. A study by KPMG published in January 2015 shows that the company is a low-cost provider of home-care services, and that this is not attributable to its patient mix. When the patients’ nursing home, physician, and hospital costs were added to the analysis, total per-patient costs were about average for the Netherlands.