"Health insurers said they also envisage lots of administrative problems. "

Absolutely! They always seem to have problems with even the simplest of things.

It's already so brain taxing for the Dutch health insurance company staff trying to just read all the info that we have to provide (what, it's a few lines on a page or two!!!) that they plain cannot cope.

e.g. Provide a Dutch Health Insurance Co with your Bank Acc details and signature (on the same page) allowing them to take payment automatically from your Account ... guess what! ... No way! ... they either cannot read, or they ignore this... and then send fines for non-payment of premium.

They expect us to pay them, and their money recovery bullies, for their mistakes! EU should seriously take a look at how Dutch Health Insurance Companies are run. Job for Nellie maybe!

Try reasoning with them over the phone is impossible as they say they will resolve it but never do. Even a Dutch Social Worker speaking in Dutch could not reason with them and get them to do as they said!!!

Email and letter seems to get better results but it still takes time, energy, effort, frustration and hassle that shouldn't be happening.

By Gerard | January 29, 2010 7:31 AM

I smoke when I'm out due to Dutch Health Care Policy and Medical Need but I prefer not to smoke.

Having said that Dr's tell me my lung x-rays are perfectly clear. In fact they cannot believe it and usually ask for the x-rays to be taken again! And then, I explain that I do not smoke tobacco!

Health minister Ab Klink - How about those who have to smoke thanks to your Health Policies?

Where do the better Doctors send patients with certain medical needs?

What do they tell us patients to do?

Where do Hospitals have to send some very seriously ill patients to keep them as pain-free as possible, alive, and well, when they are not allowed by Your Policies to provide Urgent Medical assistance and prescribe needed pain relief?

This is Basic Human Rights?

By Gerard | January 29, 2010 7:46 AM

Skinny people who don't smoke can also lead unhealthy lifestyles. Ever see a fat heroin addict?

But seriously, a skinny person can eat nothing but garbage or drink too much or laze around.

This idea is just unworkable.

By CW | January 29, 2010 8:24 AM

so with the same logic those women for example with a genetic predisposition to breast cancer should pay higher fees e.g BRCA mutation carriers..etc..dont forget per packet a smoker pays 300% of the price of cigarette in taxes. it is amazing what i hear here.

By kos | January 29, 2010 8:27 AM

Great idea, lets then make people who are overeat and are obese pay more and then anyone who plays sports and suffers lots of sports injuries, anyone who has sex and catches sexual diseases,anyone who has a drink problem,anyone who travels overseas and catches diseases from overseas need I go on....everything we do in life has a risk and THAT is why we pay for our health insurance and pay taxes upon the things we do that is bad for us....just another excuse for them to make even more money out of us as usual.

By Carol Turnham | January 29, 2010 8:36 AM

"And health insurance fees should also be higher for people on better incomes, Nos quotes the council as saying. This would prevent poorer people, who tend to be unhealthier, from bearing too much of the cost."

This is damn socialism, Robin Hood thing. I don't see anything reasonable here. Totally unrelated to health condition and to the rest of the proposal.

By Konio | January 29, 2010 9:37 AM

smokers already pay extra in the form of tax. People who do sport are more likely to be injured and be a burden on the health system. People on higher incomes also pay more tax towards healthcare.

Leave it alone

By Mark | January 29, 2010 9:43 AM

We start with asking more money from smokers, than from overweight people, from those who do not run every day, from those who drink less than 2 and more than 4 cups of coffee... How about those who have stressful work? They have higher risks, let’s make them pay. What about people with two jobs? People who do not take 'proper' vacations? Hey! Let’s make homeless pay extra, 'cause their lifestyle is not healthy.
Why not just saying "please, give us any money you have"?

By Peter | January 29, 2010 9:53 AM

I used to be a Non-Smoker most of my life.

I did try a few cigarettes when a teenager but didn't like them and so didn't bother.

In my 40's I had to be taught, step by step, how to smoke by a Consultant Nurse Specialist in Pain Management.

By Gerard | January 29, 2010 11:26 AM

Stop selling tobacco and end the problem. When something is legal how can someone be fined for it? Focus on the young and put photos of smoke damaged lungs in the school halls. The same goes for overeating, show the young how disgusting obesity is and the numerous health problems that come from it.

By Paul Martin | January 29, 2010 12:08 PM

smokers must be the cheapest people around for the state. They pay extra tax on tobacco which pays towards subsidising everyone's healthcare. When they get smoking-related diseases they're generally quick to die and younger on average. In the mean time all those moaning, boring healthy people live till they're very old claiming a pension and clogging up the healthcare system with age-related diseases for years and years while the next generation has to pay for them

The government should give smokers and unhealthy people a break. They more than do their bit for society

By Mark | January 29, 2010 12:29 PM

the thing I resent most about the privatised dutch health insurance system is the obscene profits made by the companies offering the insurance. That a nation should contribute even a cent towards profit on the back of a basic government duty (the nation's healthcare) is abhorrent to me.

But it's no good ranting, the fact of the matter is that we have a private insurance system and we must make it as fair as possible.

Time and time again it is proven that those on lower incomes bear a heavier tax burden than those on higher incomes and I think something must be done there. So the idea of means-testing your premium is one that get's my full suppport and can be introduced in a flash. I actually feel guilty that I pay the same premium (with same disgusting personal excess to be added to the premium cost) as a pensioner or factory working living on minimum incomes.

The idea that those with distinctly unhealthy lifestyles (smokers are the biggest burden on the health system folks, it's a fact) should contribute more is also a good one on paper. As others have pointed out though, i believe it's impossible to put into practice. Why don't we copy the danish system: those things deemed unhealthy such as cigarettes, alcohol and overly fatty foods are taxed at source and that money goes straight to the danish health system. So yes, a tax on prodcuts already taxed, but at least the danish government can't take the income generated for the health system and by a useless bunch of american fighter jets with it!

By john | January 29, 2010 12:46 PM

I wonder whether people eat fast food have to pay higher premium ?

People who don't do exercise pay higher premium ?

vegiterians and non-vegiterians have different premium ?

GUYS, stop this stupidity. Think before act.

By McDonald | January 29, 2010 12:49 PM

Well said Paul Martin!
Tobacco is the only legal product in the world which directly causes serious health problems WHEN USED AS INTENDED. But then governments depend on taxing this killer drug that they legalise.

By AC | January 29, 2010 12:49 PM

As a childless person, I'm paying for 'kraam care' and all the costs of people who choose to have children. My husband is also paying even though he doesn't have a womb.

By Niala Maharaj | January 29, 2010 3:28 PM

Councils in Holland often come up with all kinds of recommendations. To provide more insight into the reasoning behind the recommendations, I'd like to suggest to all editors in Holland to mention of who the council is made up, and which interests they directly or indirectly (professors sponsored by companies) they represent.

By Hans | January 29, 2010 3:29 PM

What will be the criteria to determine who is a smoker and who is not?

Stop sale of cigarettes completely.

By DusXpress | January 29, 2010 3:34 PM

Yeah right, what about passive smokers, do they get a refund??? treating the symptom and not the cause again!!

By Zen | January 29, 2010 3:48 PM

Mixed opinion on this - I personally am very healthy, I eat very well, I exercise several times a week and participate in many running competitions. But I smoke.

Some of you have said that sports people have injuries - yes this is true, but in fact you will find that fit and healthy people not only heal faster but also are far less likely to develop a secondary infection, or need additional treatment. Also people who exercise regularly are far less likely to injure themselves "normally" e.g. falling down the stairs etc is less likely to cause injury for a sportsman than someone who never exercises.

I come from the UK where there is a free health service for all. This system of course does not discriminate as everybody pays their "premiums" through the government in tax form. The result is a system which is pushed to the limit by unhealthy living. This results in some patients being unable to obtain treatment as there is not funding available. This has led to long waiting lists, cheaper (less effective) treatments and overworked staff.

Here we have an option to prevent the unhealthy from hurting the healthy. As a smoker I would be happy to pay an extra premium, based on the treatment I am likely to expect to receive given I continue my current lifestyle. Why wouldn't I?

Put yourself in someone else's shoes for a second. Imagine you have just been diagnosed with a rare bone disorder and you need very expensive treatment. But you find out that the medical system has no funds left because the people before you spent it all - then you find out that these people were not ILL, but needed treatment because of a bas lifestyle. They ate too much junk food, smoked too may cigarettes and have blocked their arteries.

Explain that one to your 5 year old child - daddy is going to die because they spent all the money fixing the fat man who lives in McDonalds.

By Obvious | January 29, 2010 3:59 PM

I don't like it when people smoke but studies actually debunk a lot of what we think to be true about lung cancer, etc.. same as with obesity, it is NOT a black and white situation! It's very GREY (no pun intended lol). It should be equal for all no matter your health needs or income.

By LJK | January 29, 2010 4:02 PM

Also wanted to add that the more news I read about health things here, the more I think NL is trying to be America... and I moved AWAY from there! If I wanted American healthcare, I'd still live in America!

By LJK | January 29, 2010 4:03 PM

What country can I live in where my every move isn't judged and taxed? How about what I do with my body is my business? Gosh I'm so annoyed...

How can they prove if you are a smoker or not? An xray? Some people prefer not to be subjected to such tests when medically unnecessary! How about the overweight? Will they watch what you eat for a week and then decide your bill? Otherwise it's not fair. A skinny bitch can have 2 pizzas in one sitting and a fattie can sit down to a nice salad and water yet the fattie has to pay more? Oh yes, how fair!

By LJK | January 29, 2010 4:08 PM

Although I agree in theory that people who smoke should be responsible for their smoking related treatments (regardless of whether they are paying tax on a packet of cigarettes or not)I also don't see how they can effectively introduce this by increasing premiums. Maybe they should be liable for a larger excess if they are treated for a smoking related problem. We all know that smoking is deadly, people who smoke are doing so with the full knowledge that they are damaging their bodies, so I don't see why everybody else should be responsible for paying their health bills.

By Chudleigh | January 29, 2010 4:11 PM

and old people should pay more, diabetics should pay more, women in the age of giving birth should pay more, people biking a lot should pay more, people eating junk food should pay more.. and then what????

By Thomas | January 29, 2010 4:37 PM

Has it ever occurred to people why health insurance is more expensive than necessary? Yes, the insurance companies!

If the guv could just reform the health system like the US is trying to now.

How about us paying our monthly premiums directly to the local hospital, or, of own choice, thus cutting out the middle man - the ziekenfonds suckers?

I'm pretty sure hospitals would welcome such an idea and be only too pleased to take on some extra administration.

I wonder sometimes how much these insurance companies make in profit over twelve months, from our health.
It just doesn't seem right to make huge profits from a person's well being.

So first smokers
then:
overweight
junkies
alcoholics
anorexics?

"Health S-care service?"
"Steal-th s-care ser-vice?"

By stevie | January 30, 2010 12:57 AM

Governments will pick on what is unpopular and "in" to raise taxes. Ministers are obviously not getting enough of a pay check and non smoking is the agenda of the day and the excuse to pocket some more money and make a name for themselves. I have read all the comments and have some of my own - athletes have died very young of heart attacks. Actors and very young people have decided to end their life. Governments give their approval to food that has nothing to do with fresh and meat certainly isn't one of the ingredients - greasle, bones, lots of chemicals to keep it "alive" are the main ingredients and it's legal. So are the "fresh fruits products" that are sold everyday, in the civilised countries and have been stored for months, treated, injected, painted, defrosted and sold as fresh and basically can kill anybody, everybody, who hasn't got perfect genes. I'm not even getting into pollution, water, chemical and nuclear plants who threaten the lives of normal citizens on an everyday basis. I do come from a third world country, have smoked from the age of 13 and I'm now 57. I'm not a burden on any country, I'm not on medication, eat and drink and I'm very healthy because I avoid civilised countries and their "fresh, legal, produce" and resent the bull I get on an every day basis. Can't stand the way societies try to take advantage of the weak and never give to the poor. Governments have their agenda, smoking happens to be the dish of the day. The day will come when obesity, abuse of the body and death for actors, models, drugs, prostitution ... will follow and they will tax them for it too if they run out of smokers. Like the wars, where they have to try and get their name in history, anything that will bring money into government coffers to sustain their high living, will follow. I'm not talking about stars or politicians, or bilionaires. Governments won't often touch them - unless they become a liability and generally speaking they are very generous to the governments if they want to stay untouched. Governments will sure go for the vulnerable. I'm sure politicians will not only smoke where they aren't allowed to, they will never suffer cut backs on healt care. Somebody will have to pay for it and guess what? It's you and me.

By Eduarda Chalmers | January 30, 2010 1:15 AM

Yet another attempt at Social Control

By JP | January 30, 2010 1:33 AM

@ LJK

You have hit the nail on the head. This is less about governments taxing people - it is about People Judging their peers and finding them wanting.

We live in a society where 'Freedom of Speech' is sacred to the point it cannot be discussed without reverence. But freedom to have a cigarette, put on a little weight, or even dare to have a children! is greeted with scorn and derision from certain members of society who aren't of the same mindset as you.

I'm overweight but not obese. I walk everywhere. I didn't fall off my bike in the recent icy spell, nor shatter my leg in a skiing accident, like some of my 'healthier' peers did, but I don't dispute their right to healthcare. Insurance is there for 'when' you need it, although hopefully you never will. Nobody knows if/when the dreaded 'Big C', or MS, or Alzheimers, or some other chronic illness will strike them down - THAT is why you pay your insurance; not to fund others, but because one day you are probably going to get real value from every cent you paid into the system.

By osita | January 30, 2010 10:34 AM

Maybe people who are smokers, obese, lazy,etc. should be charged more, but first have a medical evaluation and then given 6 months to improve their health (if improvment is necessary). If they do improve,fine...if they carry on hurting themselves, well why should anyone else care?

By AW | January 30, 2010 11:11 AM

Everyone should be made more responsible for their own behaviour. The social care system simply does not work.

May be it is time to accept that life is unfair and that some people can afford to be obese and treat consequent complications while others cannot.

By Kira | January 30, 2010 1:13 PM

Interesting......most people who posted here seem to be against the proposal by the healthcare council.

Yet, the poll shockingly has the most votes for: "Yes, why should I pay for their bad habits."

My father-in-law started smoking when he was 11 yrs old and died at 92 from unrelated causes. I know people who never smoked and died from lung cancer.

It's very hard to tell what people will die from eventually because medical problems can result from being exposed for a lifetime to all kinds of influences: smoking, eating too much suger and white flour, dust from asbestos brake linings in cars, other poisons in the environment, radiation from hydro-electrical and cellphones perhaps, too many to mention. There is very a long list of man-made substances and behaviours, not to mention natural (unavoidable) substances that are harmful.

Bottomline: Thumbs down on the proposal.

By KenM | January 30, 2010 8:53 PM

All of it reminds me "Adventures of Cippolino" fairy-tail by Gianni Rodari: "We introduced taxes on air, but since then you breathe less. Therefore, we introduce taxes on rain, snow and especially thunderstorms."

The system should by all means support those who are capable to work. Those produce wealth to support the weak. If workers get extinct, their families will also join the weak, so the balance will be destroyed even more. MP's want to shift social structure by supporting laziness and by diminishing of average IQ. Film "Idiocracy" (2006) is our future!

By nik | January 30, 2010 11:10 PM

This sounds so weird to me.Just last year, the insurance companies stoped giving back some money to those who do not visit docotor in one year. That was pretty efficient method to make people feel responsible. Now they want to charge more smokers, what a crazy and greedy idea!
Implement the previous system. Those who lead healthy life don't visit doctors and hence deserve money back from insurance. Those who "smoke" or lead unhealthy life visit doctor often and hence get nothing back. easy ha?!
vroger was alles better!

By Milli | January 31, 2010 1:33 AM

I have also heard that eating very "rich" food with lots of fat and cream is very bad for you and causes many illness. I was just thinking how the politicians eat...since most are all from the upper dutch class, I'm sure their cooks don't prepare "underclass" food. Lets check with the queen and see what they are served.

By alanposting | January 31, 2010 12:26 PM

This could work for the people (not sure if for insurence companies).

Encurage and not scare, therefore let healthy people pay less. Yup, one thinks: I am healthy, does what nessesary (test, present some results...) and pays less.

It is a shame that is is always about punishing and not suggesting a better way in a positive matter.
I think If I would be presented with oportunity (something like drop 7kg I guess) by my house doctor suggesting that then it would be ideal and knowing that I would be granted with some discount I would have even more motivation to change . Just a thought.

By sumone | February 1, 2010 8:19 AM

The Netherlands is acting more and more like the USA, allowing the privatisation of health insurance and now allowing them to charge whatever they want. Soon, the average middle class Dutch citizen will not be able to afford health insurance due to greed.

By sandra | February 1, 2010 1:54 PM

This is total madness! It hurts the basic principle of solidarity that is part and parcel of any insurance. It is no longer about sharing risk equally among the group, but about singling out those who run a greater risk. That sounds familiar, does it not? Previous comments point out the similarities with the USA which are indeed striking. (For a full analysis see my recent blogpost on this matter at http://bit.ly/awPV0R)

By britishdutchman | February 1, 2010 6:17 PM

If one would mention this, one should also metion alcohol drinkers, regular fast food eaters, ones that refuse to do any sports...?
would this be things we all would like to disquis?

By Beef Jerky | July 5, 2010 12:48 PM

Another hilarious Dutch idea ... In the Netherlands people can be in two conditions; healthy or dead. I believe if the government stops paying doctors who doesn't do anything (almost 99%) can save the economy so that they can stop proposing such absurd ideas ...

They basically want to reduce the demand because doctors are useless and they don't want it to come out. I'm paying insurance because I have to. Time for some expat doctors who can do something.

By Gokce | July 5, 2010 2:20 PM