The election results do not appear to lead to a system change in the healthcare landscape. But whether that also means an unchanged course? After all, the challenges for the sector are piling up; in the field of the labor market, digitization of healthcare, regional cooperation and of course financial frameworks.

In the run-up to the IngendaelDiscourse in August, we will discuss the main challenges and incentives that the new coalition agreement should achieve during this online meeting. But also what ambitions and challenges the sector sets for itself.

Not a new plan, but a better analysis of the system and structural problems?

The big question for Public Space is whether a better political analysis of the health care system is going to be made than before.

Steven de Waal has described the system several times, for the first time in 2011 , and then in many lectures, as ChinaZorg: a bit of market on the edges, rest communist state control, in the Netherlands further hidden behind many polder consultations, involving private parties from care providers and health insurers seem and think they have something to say. The main reason for him to talk about ChinaZorg is that the patient hardly has a choice in the care offered: people are referred, are prescribed a diagnosis and therapy and can only accept it. While here too the ‘ disruptive power of patients ‘ ( derived from his 2018 book with many international lectures on ‘the disruptive power of citizens’) has increased enormously due to the new technology: peer groups of patients about providers and treatments, own data analysis on the web about disease, diagnosis and prescribed treatments, intensive exchange platforms of patient associations. Most administrators and doctors, let alone politicians, have no idea how far this knowledge and exchange between patients is now. In that choice and therefore influence and clarity about their preferences, patients have hardly anything to say (unless they are very rich and can arrange it privately with additional payments and, if necessary, abroad) and this system is therefore absolutely not a market system. In addition to the fact that as a result of this and the chosen output funding, there is also too little attention for public health and prevention, as was already noted in thePvdA 2005 report ‘Ensure a healthy life’ , under De Waal’s chairmanship. The reason that politicians do not really know market mechanisms is of course known in itself, but here also plays the political convenience that every member of government has an interest in maintaining this market myth. He / she can therefore never be held truly and integrally responsible for it! That is of course also the reason why this myth has been upheld for so long. Such a sharp and integral analysis is desperately needed for any structural approach and transformation. Are you curious about whether the new cabinet will work on it?

Steven de Waal is moderator of the Ingendael Discourse.