Healthcare Authority punishes CZ, but waiting lists are a problem across the board: 'They can't just open a can with staff'

Never before did the regulator have taken such a far -reaching measure, one reprimand Who can cause a lot of damage to the reputation of CZ (four million customers). The timing is interesting: not in the transfer season, December, but two months later. CZ is saved a large competitive disadvantage.

The NZa stated last year in March that two health insurers did not meet their duty of care. They were not yet mentioned by name, that would only happen if insufficient improvement had been improved after six months. Insurer Menzis, the other insurer, passed this test. CZ fell.

Duty of care is about what insurers are obliged to do to arrange the best possible care for their customers, who in turn, also obliged, pay a monthly premium. An important part of the duty of care is that insurers make care accessible. It should not be the case that people have to travel too far for it, or that they have to wait too long.

You cannot address health insurers about their duty of care, but then do not provide them with the information to do waiting list mediation

The latter in particular has been a growing problem again in recent years. « Access to care is no longer a matter of course, » said the Healthcare Authority. Where waiting lists and times in the years before the Corona Pandemie sector -wide were relatively manageable, they have been rising considerably since then. In mental health care in October last year, more than 100,000 people were on waiting lists, says advocate Mind. In reality, that number is somewhat lower because some of the people are on multiple waiting lists.

Waiting longer

Often people who need care have to wait longer than is recorded in the so -called Treek standards. For example, in GGZ it is intended that a patient can be treated for a maximum of fourteen weeks after the registration. The intake interview must take place four weeks after registration, then the treatment must start within ten weeks. Especially people with personality and eating disorders await on average on average, while research is known that problems often aggravate.

Although the NZa's announcement does arouse that suggestion, it is not that CZ customers have to wait longer for care than customers of other health insurers. CZ does not do enough to evaluate and adjust the waiting times that should reduce waiting times. A spokesperson said he was 'quite grumpy' about the measure of the Healthcare Authority, and to understand where it comes from.

Duty of care

« Insurers have a public function and must therefore be able to answer, » says Professor Peter Groenewegen of the Netherlands Institute for Health Care Research (NIVEL). « If you have duty of care, you must be able to prove what you are doing to improve. You can't get away with « We are doing our best and it's not easy. »

It is therefore logical that the NZa appeals to an insurer on the shortcomings. And also good, says Marco Varkevisser, professor of market regulation in health care at Erasmus University. « A supervisor who barks but does not bite becomes a stump instrument. Now there is a bitten bitten.  »

At the same time, he notes that it is not the case that the CZ or other insurers can be blamed that the waiting times in healthcare have risen so much. « Even if CZ does everything according to the book, there is no guarantee that this also leads to a better outcome. Waiting lists run up across the board and that is mainly due to staff shortages and the growing demand for care. You cannot expect insurers to realize timely care for everyone. They can't just open a glance with staff. « 

What also strikes Varkevisser is that the NZa explicitly appeals to healthcare providers about their share in the long waiting times. The press release states that the supervisor of care providers expects « transparency about their waiting times » and also « a proactive attitude » to reduce it together with health insurers.

Health insurers are increasingly complaining about the lack of resources to do something about the long waiting times. That also complicates waiting list mediation, which means that people who have been on a waiting list of a care institution for a long time are linked to healthcare institutions where they can go faster. Insurers must provide that service to clients who therefore ask.

Not accurate or up -to -date

Research by the VU, commissioned by health insurer VGZ, showed last October that the waiting list information from GGZ institutions in the Netherlands clearly leaves something to be desired. According to the researchers, data on waiting times and waiting lists are 'insufficiently reliable'. On the one hand, it is therefore unclear whether the long waiting times at the preferred care provider are correct, on the other hand, insurers often have no idea where they can place their customers. Because that information is often not accurate or current.

Another problem is that health insurers are not allowed to know which of their customers is on a waiting list for mental health care help. This is prohibited by privacy legislation. « I don't know what waiting list they are on, I don't know how long they have to wait, I don't know what to wait for, » said Menzis CEO Wouter Bos at the end of last year at Omroep WNL about his 1.9 million insured persons. « The privacy card is put on the table a little too quickly in the Netherlands, » says Varkevisser. « You cannot address health insurers about their duty of care, but then do not give them the information to do waiting list mediation. »

To share





Mail the editors