Yesterday, 12:00 • 6 minutes reading time
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THE HAGUE – Negotiations between the insurers and hospital HMC are difficult. So difficult that HMC called on patients to look for other insurance while it was still possible. An action that led to many shocked reactions. The Dutch Healthcare Authority even warns against deception. But what’s next? Ten questions and answers about the dispute.
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What is going on?
Every year, hospitals and health insurers negotiate contracts for the coming year. In this they make agreements about, among other things, the healthcare costs. These negotiations do not always run smoothly. For example, the HMC has already made agreements with a number of health insurers for 2022, but not yet with VGZ and Menzis, for example.
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Why are the parties unable to reach an agreement?
According to HMC, the two insurance companies are demanding that the HMC cut spending next year. ‘In these times, when so much is already being asked of care, it is incomprehensible to talk about budget cuts,’ says CFO David Voetelink. ‘You would expect these two health insurers to invest in healthcare instead of imposing additional cutbacks. But instead, these two health insurers are asking us for unacceptable discounts. They therefore demand draconian cutbacks.’
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The HMC says that the insurers want to cut the hospital for about 15 million euros. This means that the hospital in The Hague can spend a total of about ten percent less in 2022. The Menzis spokesperson says that it is ‘sensitive’ at this time, but that it is up to insurers to keep care affordable in the future. She would not say whether that means that austerity measures are indeed being urged.
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Is it bad if the parties take longer for the negotiations?
If there is no agreement, the current agreements officially no longer apply. In the worst case scenario, this could mean that people who are insured with VGZ or Menzis would have to pay for their treatment in the hospital in The Hague themselves and then have to reclaim the money from their health insurance.
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The HMC even warns that people who are insured with VGZ or Menzis will lose more money next year if no agreement is reached. Patients would then have to pay the price charged by the HMC, but would be reimbursed a lower amount from their insurer.
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Are there ways to avoid those higher costs?
In their statement about the negotiations, the HMC calls on people to cancel their health insurance with VGZ or Menzis and switch to a party with which they do have an agreement.
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In this way, patients know for sure that the bill for their treatment will go directly to the health insurer. They don’t have to make any advances anyway and they don’t have to worry that their treatments will become more expensive.
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That’s a strong statement. But isn’t this primarily a negotiation technique?
Moreover, the statement of the HMC is incorrect, says Menzis. ‘As long as we are sitting at the table, the agreements of this year will apply. Even if we don’t figure it out before December 31st.’
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How have health insurers responded to the HMC’s call?
Menzis and VGZ do not want to say too much about the statements of the hospital’s financial director. Those insurers leave it at that: ‘We conduct negotiations at the negotiating table and not through the media.’
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Zorgverzekeraars Nederland, the umbrella organization of all health insurers in the Netherlands, is also not happy with the call. “It is undesirable that unrest is created among policyholders, and that is happening now,” said a spokesperson.
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Even the Dutch Healthcare Authority has already interfered with the ruling. They weren’t happy either?
‘We see that some hospitals are trying to persuade patients to switch as a result of negotiations with health insurers. They are not allowed to do this,” the authority said. According to the NZa, hospitals are actually allowed to report with whom there is already a contract and with whom not and what the consequences are, but nothing more.
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‘If healthcare providers advise patients to switch during their own contract negotiations, this could be a matter of deception,’ says the NZa, without naming the real culprits. ‘Examples of deception are healthcare providers who provide subjective or one-sided information about a healthcare insurer on their website. This puts patients on the wrong track.’
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That’s a lot of criticism. Did the call make sense?
That, of course, remains to be seen. But at least it has loosened up a lot. Not only with the parties that are negotiating, but also with the public. The hospital in The Hague received many reactions from people who were being treated in the hospital in the days after the call.
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Conny Rodijk from Voorburg is one of them and she is very concerned. ‘I immediately panicked’, says Rodijk. ‘I am being treated by a urologist in the hospital. If that is not reimbursed, I will soon have a hefty bill under my nose. We don’t have a car, we do everything by scooter or public transport. If you then have to go to the other side of the country… They should have arranged this at the beginning of the year. I am happy with HMC and Menzis. I want it to stay as it is.’
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Can’t The Hague’s politicians do something for its inhabitants?
Nevertheless, it is important for the municipality of The Hague that an agreement is reached between the parties. Last year, the municipality concluded a contract to pay the insurance premium of 50,000 low-income residents of The Hague. That costs the municipality about 50 million euros per year. This agreement has been concluded with: VGZ. These people cannot therefore switch to another health insurance policy, because the Hague health insurance only runs through VGZ.
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That is why the alderman has contacted the parties. ‘I have indicated that the city council does not want the minima to become the victims of the ongoing negotiations between VGZ and HMC. I find it unacceptable that this is being fought through the media and over the backs of vulnerable people.’
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But what’s next?
The parties must reconvene with each other and find a solution. However, the parties have been called on to conduct the negotiations behind closed doors from now on. The healthcare authority calls on healthcare providers to ‘not involve their patients in discussions about healthcare procurement’.
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The NZa, in turn, points out to health insurers that they must inform people well, including with whom they have or have not yet concluded a contract. The authority also asks the insurers to give the care providers sufficient financial leeway during this difficult time. In other words: all parties mainly appeal to the parties’ common sense and to come to an agreement this month.
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