NZa can do more for transparency than it actual does
The Dutch Healthcare Authority (NZa) has enough room to enforce transparency of healthcare costs but has left this unused. During its investigation for the appeal at the Council of State, Open State Foundation found that the Dutch Healthcare Authority already can set rules on healthcare providers and health insurance companies to provide information to citizens. This involves data on prices and tariffs, the cost structure of the prices and the content and quality of products and services disclosed in such a way that this information can be easily compared by everyone.
The annual reports of the Dutch Healthcare Authority in 2012 and 2013 noted that transparent information is one of the three public interests in healthcare that is covered and supervised by the Dutch Healthcare Authority. Remarkably, the importance of clear information has been omitted from its annual reports since 2014. However, it has become clear that the Dutch Healthcare Authority can oblige transparency from insurers and healthcare providers and enforce this if it wishes to do so.
The law even sees it as a task of the healthcare authority to set rules on this matter. The Dutch Health Authority can intervene when insurers and healthcare providers refuse to disclose certain information. It can even own, collect, enhance and publish information itself. The Dutch Healthcare Authority may set rules so that information becomes available to citizens. This involves providing data on prices and tariffs, the cost structure of prices, content and quality of products and services in such a way that these data are easily comparable to everyone.
Transparency is crucial to make informed choices
‘For the healthcare system it is crucial that people are able to make an informed and free choice of healthcare provider and health insurer’, says Arjan El Fassed, director of Open State Foundation. ‘Many people have no idea what a hospital treatment costs while the vast majority of healthcare is paid from public funds.’
It already should be possible for a citizen to find information about the financial consequences of different choices for medical treatments at a specific healthcare provider. Also it should also be known what costs are to be paid by themselves and what consequences this would have for excess deductible fees. As citizens also need this information to finally make a choice between health insurers and health care providers, the room the law provides is broader than the NZa allows itself in its defense.
‘Time after time, the Dutch Healthcare Authority says it is in favour of price transparency in healthcare but that law prohibits it. Billions of healthcare euro’s are spent shadowy’, says FOIA-expert Brenno de Winter. ‘It is increasingly clear that we can have access to information on healthcare costs and that the legislature really wanted this’.
Last year, Open State Foundation, assisted by FOIA-export Brenno de Winter, appealed to the Council of State to get data on tariffs and prices of medical treatments as declared by healthcare providers. In 2014, Open State Foundation filed a FOIA-request with the Dutch Healthcare Authority to make the tariffs, prices and volumes of medical treatments public. In October 2015, the District court of Amsterdam ruled that the Dutch Health Authority could keep secret all information related to declared health costs and tarifs of health products.