A lower deductible? Health economist Martin Salm warns of rising healthcare costs 

If it’s up to the Dutch cabinet, the healthcare deductible will decrease from 385 to 165 euros in 2027. But is this really such a good idea? ‘Lowering the deductible will further increase pressure on the healthcare system,’ says health economist Martin Salm in his inaugural address.

The coalition agreement of the Schoof cabinet includes plans to reduce the healthcare deductible by 220 euros starting in 2027. This measure aims to make healthcare more affordable for everyone. Additionally, the cabinet hopes that the reduction will lead to fewer people avoiding necessary care due to high costs.

However, health economist and professor Martin Salm, who gave his inaugural lecture on Friday, November 1, expresses concerns about the possible consequences of this measure. According to him, lowering the deductible would only increase demand for healthcare, as well as the pressure on the healthcare system.

Effects of the deductible 

Together with his colleagues, Salm has conducted research in recent years on the influence of economic measures on patient behavior. They also examined the deductible and other ways of sharing healthcare costs, such as health insurance premiums and co-payments.

According to Salm, the idea behind the deductible is that people are less likely to use unnecessary care, as they pay a portion of the costs themselves. ‘However,’ he says, ‘during our research in the Netherlands, we observed that patients reduced healthcare consumption in both less urgent and very urgent cases, such as treatments that need to be carried out the same day. This suggests that the deductible can lead people to delay or avoid essential care, too.’

Research also shows that a lower deductible, as currently proposed by the cabinet, could result in healthy people visiting the doctor more frequently, as healthcare becomes more affordable. This only increases healthcare premiums, tax contributions, and pressure on the healthcare system.

Alternative measures 

There are alternatives to lowering healthcare costs, but according to Salm, each alternative has its pros and cons. For example, there are no-claim discounts, where insured individuals receive a refund if they incur few healthcare costs. Additionally, doctors could be encouraged to save on costs.

This all sounds good, but ultimately the total savings are lower than if the deductible is maintained. ‘One thing is clear,’ says Salm: ‘lowering the deductible will drive up demand for healthcare and further increase pressure on the healthcare system.’

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