Majority of Dutch say smokers should pay higher health insurance premiums

A slight majority of the Dutch population think smokers should pay more for health insurance, according to a national statistics agency (CBS) report published on Tuesday.

CBS writes that currently, Dutch healthcare “is based on the principle of solidarity whereby everyone, via the health insurance premium for the basic package, contributes to the payment of the health care costs of both themselves and others. This premium is the same for everyone…regardless of differences in personal characteristics and lifestyle.” Yet 52% of adults surveyed said health insurance premiums should be higher for smokers and 45% of adults said heavy drinkers should pay more. Additionally, nearly a quarter of those polled said overweight people should pay more for health insurance.

Nonsmokers were especially critical of their smoking peers, with 58% of non-smokers favoring higher insurance premiums for smokers. 20% of smokers polled favored a higher premium for themselves.

More than 40% of those polled said people with a healthy lifestyle should pay less for health insurance. 42% favored lower premiums for non-smokers, one-third of those polled favored lower premiums for non-drinkers, and less than 30% said those with a healthy weight and receiving sufficient exercise should pay less.

The report also investigated solidarity, noting that this and an earlier report indicate “people are generally less in solidarity with people who live unhealthily,” and “people are more in solidarity with groups to which they belong,” such as with “people who are seriously overweight…identify[ing] relatively strongly with people who are overweight.”

A large majority (81%) of respondents said people genetically predisposed to developing a serious illness or condition should not pay higher healthcare premiums despite the likelihood that this population – like those who live an unhealthy lifestyle – may require greater use of the healthcare system. 16% said the premium should be reduced for this group and only 3% said these people should pay a higher premium. CBS notes this solidarity “is probably due to a lot of people thinking that this is a powerless group that is not to blame.”

The conclusion of the CBS report questioned to what extent an unhealthy lifestyle is a personal choice. CBS writes when it comes to maintaining a healthy lifestyle, “research shows that both a genetic predisposition and environmental factors, as well as an interaction between the two can play a role.”


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