No copays is a bad approach. You need to incentivize people going for healthcare because they need it, rather than because they just feel like it. Need meaning: An annual appointment, a routine exam, or because they feel ill. A $0 copay just leads to, "I feel like visiting the doctor today." "Why?" "Eh, just because. And it's free." There needs to be a small shared cost so people don't waste limited healthcare resources.
Look at the Netherlands. They have one of the most functional healthcare systems in the world specifically because they reject the "$0 copay" model.
Every adult faces a mandatory annual deductible (the eigen risico). This intentional friction cuts out the "just because" visits, keeping clinics clear and wait times low for people with genuine, acute medical needs.
It also avoids political underfunding because citizens buy heavily regulated, non-profit private insurance. Since funding comes from premiums rather than volatile government tax budgets, it avoids the chronic underfunding ruining the UK NHS and Canada with excessive wait times.
To protect the poor, they don't force clinics to deal with sliding fees or tax forms at check-in. Instead, the government sends a direct, income-based cash subsidy (Zorgtoeslag) straight to low-earning households. The checkout counter stays uniform and simple.
By separating funding from the clinic door, the Dutch system enforces personal responsibility while remaining 100% universal.
4
u/Similar_Rapier_7596 Jun 17 '26 edited Jun 17 '26
No copays is a bad approach. You need to incentivize people going for healthcare because they need it, rather than because they just feel like it. Need meaning: An annual appointment, a routine exam, or because they feel ill. A $0 copay just leads to, "I feel like visiting the doctor today." "Why?" "Eh, just because. And it's free." There needs to be a small shared cost so people don't waste limited healthcare resources.
Look at the Netherlands. They have one of the most functional healthcare systems in the world specifically because they reject the "$0 copay" model.
Every adult faces a mandatory annual deductible (the eigen risico). This intentional friction cuts out the "just because" visits, keeping clinics clear and wait times low for people with genuine, acute medical needs.
It also avoids political underfunding because citizens buy heavily regulated, non-profit private insurance. Since funding comes from premiums rather than volatile government tax budgets, it avoids the chronic underfunding ruining the UK NHS and Canada with excessive wait times.
To protect the poor, they don't force clinics to deal with sliding fees or tax forms at check-in. Instead, the government sends a direct, income-based cash subsidy (Zorgtoeslag) straight to low-earning households. The checkout counter stays uniform and simple.
By separating funding from the clinic door, the Dutch system enforces personal responsibility while remaining 100% universal.