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Table 1 Key elements of the Dutch health care system (From: Enthoven and Van de Ven, 2007)

From: Acceptance of selective contracting: the role of trust in the health insurer

1 Mandatory basic health insurance for everyone, purchased through private insurance companies
2 Annual consumer choice of insurer and insurance products
3 Open enrolment and community rating
4 Premium subsidies for elderly people and those at high risk of disease, through a risk-equalisation system
5 Mandatory deductible of €165 per person per year*
6 Voluntary deductible up to €500 per person per year
7 Insurers allowed to sell other types of insurance (e.g., supplementary insurance)
8 Insurers intended to be the prudent buyers of care on behalf of their members
9 General practitioners to serve as gatekeepers
10 Insurers permitted to contract selectively with doctors and hospitals
11 Health maintenance organisations and preferred provider arrangements allowed
12 In transition toward managed competition
  1. *The government assesses the amount of the mandatory deductible every year. When this survey was conducted (end of 2010) it was €165.