Health insurance for everyone? Private health insurers and the insurance of exceptional medical risks in the Netherlands 1900–2006

Background: Until the implementation of the Zorgverzekeringswet (Health Care Act) in 2006 health insurance in the Netherlands was provided by a dual system of sickness funds and private health insurers. Approximately 2/3 of the population, those with an income below the government set income-level were insured by sicknessfunds, the other 1/3 by private insurers. Providing health insurance for sub-standard risks, the elderly, and the chronically ill, proved to be a recurrent problem for the private sector. The solutions of health insurers for this particular problem changed over time. Methods: Historical research…