D66 has got it (mostly) right, writes Barend van Lieshout.

This is the sixth in a series by Barend van Lieshout about the main parties healthcare plans.

D66 never stops talking about reform but has no intention of standing the healthcare system on its head. This is reform without structural change. And that’s quite clever of D66.

Evolution, not revolution

The D66 manifesto for health is ambitious, to say the least. D66 is not about revolution but evolution. Insurers will continue to insure, care providers will continue to provide care and patients will continue to have choice. The ambition is in the evolution bit: the party wants to apply new health care concepts within the existing system. It’s a wise choice. Healthcare reform takes a very long time and decision makers and planners might take their eye off the ball.

That would be a pity because there is plenty to do. D66 proposes to solve the main healthcare problem – exploding costs – by having people remain in their homes for longer. Living costs and services would be paid for privately. This is perfectly feasible within the existing system. D66 also wants to focus on private citizens who, by being in charge of their own healthcare budget, or as home carers, can help bring down costs. Is this innovative thinking? Not really. The personal healthcare budget (PGB) has proven how effective this kind of scheme is. But the challenge is to implement it in other areas of healthcare.

Shelf

Healthcare innovation is a slow process. There are rules and regulations to be dealt with and it takes time before any scheme can be said to work. And if they do work, they rend up on a shelf, their implementation across the board hampered by vested interests. It looks as if D66 has discovered the shelf.

So has D66 got it totally right? Of course not. D66 is treating mental healthcare organisation GGZ with kid gloves. The manifesto shrinks back from the accord health minister Schippers has agreed upon with the sector about increasing ambulant care for intramural clients. And yet it has not only been proven to provide better quality of care but is cheaper as well. The proposed tax on fat and salt content is a bureaucratic nightmare and won’t work. The question is of course if this whole raft of plans can come to fruition in one single cabinet period. Maybe D66 should prioritise. But having said that, I think the manifesto is excellent.

Barend van Lieshout is a healthcare adviser at Rebel