Dutch health expenditure 10th highest in Europe

© Hollandse Hoogte / Flip Franssen
In 2018 and 2019, the Netherlands devoted 10 percent of its gross domestic product (GDP) to health care. Within Europe, 9 countries spent more and 21 countries spent less. The Netherlands spends a relatively large amount of money on (long-term) care and relatively little on (para)medical care. This is evident from the report 'Health at a Glance: Europe 2020', published by the OECD and the European Commission.

The Netherlands spent 80.9 billion euros on health care in 2019 and 77.2 billion euros in 2018. This was equivalent to approximately 10 percent of GDP in both years, which is comparable to the share of health spending in Norway, Denmark and the United Kingdom. Switzerland, Germany and France spent the highest share of GDP on health. In 2018, the Netherlands ranked 10th on a list of 31 European countries. 2018 is the most recent year for which a comparison can be made between European countries in several areas of health care expenditure.

In determining expenditure, it makes no difference how it is financed. Included is all expenditure paid through health insurance contributions, supplementary health insurance, the Long-term Care Act (Wlz) and contributions paid by users themselves, by companies, or directly by central government. Health care according to the international definition does not comprise all health care in the Netherlands. It does not include, for example, long-term health care in the form of counselling and domestic care, and the bulk of expenditure on youth care.

Health expenditure, 2018
Land(Para)medical care (% of GDP)Long-term care (health-related) (% of GDP)Prevention, policy and management, uncategorisable (% of GDP)
Switzerland8.732.380.77
Germany8.442.130.9
France8.681.750.83
Sweden7.382.890.63
Belgium7.462.330.53
Austria8.171.520.63
Denmark7.072.530.5
Norway6.712.940.4
United Kingdom7.251.790.96
Netherlands6.52.670.8
Portugal8.620.460.37
Malta*7.131.680.5
Finland7.021.750.27
Spain7.670.860.46
Italy7.230.920.52
Iceland6.561.660.32
Slovenia6.990.790.52
Greece7.330.170.22
Czech Republic5.991.070.59
Bulgaria6.970.010.37
Ireland5.011.490.43
Croatia6.130.210.49
Cyprus6.270.250.25
Hungary6.060.260.38
Slovakia6.370.030.29
Estonia5.740.610.31
Lithuania5.810.530.23
Poland5.640.390.3
Latvia5.690.290.23
Romania4.950.310.3
Luxembourg4.010.990.29
Source: CBS, Eurostat, OECD
* 2017

In 2018, the Netherlands spent 50.3 billion euros on medical or paramedical care, equivalent to 6.5 percent of GDP. This is a relatively low amount compared to other European countries. The Netherlands ranks 19th among 31 European countries for this form of health expenditure. Switzerland spends relatively the most on (para)medical care.

At 2.7 percent of GDP, spending on long-term care for treatment, nursing and personal care (long-term health care) is high in the Netherlands compared to other countries.. Only Norway and Sweden spend relatively more (around 2.9 percent).

Over 65 percent of health expenditure in the Netherlands is spent on medical or paramedical care. This is the lowest percentage of all European countries surveyed. In Slovakia, the bulk of health spending is devoted to (para)medical care.

Distribution of health expenditure, 2018
Land(Para)medical care (% of health expenditure)Long-term care (health-related) (% of health expenditure)Prevention, policy and management, uncategorisable (% of health expenditure)
Slovakia95.10.44.5
Greece94.92.22.9
Bulgaria94.80.15.1
Cyprus92.63.73.7
Latvia91.64.73.7
Portugal91.34.93.8
Hungary90.43.95.7
Croatia89.63.07.4
Poland89.26.24.6
Romania89.05.65.4
Lithuania88.58.03.5
Estonia86.19.14.8
Spain85.39.55.2
Slovenia84.29.56.3
Italy83.310.66.1
Austria79.214.76.1
Czech Republic78.413.97.7
Finland77.917.24.9
France77.015.67.4
Iceland76.719.53.8
Malta*76.618.15.3
Luxembourg75.818.75.5
Germany73.518.67.9
Switzerland73.520.06.5
United Kingdom72.617.99.5
Ireland72.321.56.2
Belgium72.222.65.2
Denmark70.025.14.9
Sweden67.826.65.6
Norway66.829.33.9
Netherlands65.226.88.0
Source: CBS, Eurostat, OECD
* 2017

Last year, per capita health expenditure in the Netherlands stood at 4,665 euros. This represents an increase of more than 4 percent relative to 2018 (4,480 euros). Here, too, a comparison can be made with the other European countries for 2018, as long as differences in price level are adjusted for. Switzerland has the highest per capita health expenditure (adjusted for price differences). The Netherlands ranks fifth on the list. The list furthermore shows that Luxembourg has relatively high per capita expenditure compared to health care spending as a percentage of GDP. This is because a large share of Luxembourg's GDP is produced by non-residents.

Index of per capita health expenditure, 2018
landIndex of per capita health expenditure (index, Netherlands = 100, adjustment for price differences between countries)
Switzerland133.9
Norway115.6
Germany114.5
Austria101.9
Netherlands100.0
Sweden100.0
Finland*98.0
Denmark97.4
Luxembourg96.0
France94.8
Belgium93.9
Ireland90.4
Iceland81.3
United Kingdom78.9
Malta*72.3
Italy64.1
Spain63.1
Czech Republic58.3
Portugal57.0
Slovenia56.0
Cyprus47.2
Lithuania43.9
Estonia43.6
Greece41.7
Hungary39.5
Slovakia39.4
Poland38.9
Croatia34.5
Latvia34.1
Bulgaria32.5
Romania31.0
Source: CBS, Eurostat, OECD
* estimate for 2018

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