1. Dept Social Medicine Primary Health Care in The Netherlands - relic of the 20 th or saviour of the 21 th century - Niek Klazinga

2. Dept Social Medicine

3. Why The Netherlands might be of interest for the USA private insurers private practice mandatory health insurance for all citizens strong primary health care system

4. Dept Social Medicine

5. Health insurance in The Netherlands regulated private insurance market since 2006 mandatory basic insurance mandatory acceptance voluntary supplementary insurance nominal competitive premiums contribution via employer tax-based health care subsidy for persons with a low income risk-equalization fund

6. Dept Social Medicine Primary Care in The Netherlands 8000 GPs (13.000 specialists) average practice 2400 persons broad professional profile registered patients gate-keeper function solo, duo, group-practices pharmacists, midwives, allied-health professionals complementary public health system at level municipalities

7. Dept Social Medicine Quality assurance of GP care GP training, CME, visitation, re-registration National guideline programme NHG Peer-review activities Practice evaluation Emerging systems of indicators and P4P

8. Dept Social Medicine

12. Relic? eroding gate keeper function (occupational medicine, youth medicine, nursing home physician) outsourcing out-of-hours care less psycho-social care delayed organizational upscaling labour market shortages ownership shifting to other providers and insurers

13. Dept Social Medicine Saviour? embedding prevention function in primary health care embedding long term care in primary health care

14. Dept Social Medicine well developed information infrastructure high level of professionalization GPs well developed quality policies initiatives with task substitution and new professions experimentation with organizational models linkages with public health, long-term care and hospital care preferences patients and insurers potential for benchmarking

15. Dept Social Medicine