The medical profession and alternative medicine in The Netherlands: its history and recent developments.

At the end of 1993, the Dutch parliament passed the Individual Health Care Professions Bill which replaced existing legislation. The new Act brings to an end the monopoly of the Dutch medical profession. The former prohibition on alternative practitioners to practice medicine was abolished. This article addresses the question of whether the Act affects the position of medical dominance in Dutch health care. It will be argued that the new Act preserves the present position of medical dominance to a large extent. Although alternative therapies have gained greater social recognition, there is little indication that the cultural and social authority of medicine is yet being challenged in the Netherlands. However, it could be argued that the Dutch health care system is moving in a more pluralistic direction.

Private clinics for employees as a Dutch solution for waiting lists: economic and legal arguments.

Private clinics for employees have emerged on a small scale during the last few years in Dutch health care. They represent new possibilities for ill employees who have to wait for medical treatments on waiting lists. Earlier proposals to allow employers in close co-operation with health insurers to start initiatives for special clinics for employees have been confronted with all kind of arguments which were considered to form serious obstacles, from theoretical, legal and economic perspectives. The European Court of Justice plays a decisive role in deciding whether free establishment and access is approved according to the rules of the EC Treaty. Private clinics can be legally allowed in the interests of the common good. However, priority treatment of a person can only be justified if the intended purpose is justified and if the priority treatment is suited as a means to (partly) realise this purpose. Furthermore, possible negative consequences may not be unreasonable in the light of the intended consequences. In this article it will be argued that both from an economic and from a legal perspective, based on national and European law, the introduction of special clinics for employees could be allowed. The main argument is that they could be introduced on a just and equitable basis.

Cross-border health care in the European Union: recent legal implications of 'Decker and Kohll'.

In the European Union a growing number of citizens are receiving medical treatment in a country other than the one in which they are resident. This concerns migrant (frontier) workers, emergency treatment and preauthorized care. Since 1998 a 'new category' can be discerned of persons going abroad without prior authorization on the basis of the Decker and Kohll rulings of the EC Court of Justice. Local payers would, because of the Decker and Kohll judgements, be obliged to reimburse patients who travel abroad to circumvent the existing problems with the authorization rules. During the past years studies within specific so-called Euregions have been performed to analyse cross-border flows and provide some more insight in the practical and health policy consequences of the Decker and Kohll judgements. The abolishment of current preauthorization is pleaded for by many respondents in these studies. Waiting lists form an important motive (in particular in the Netherlands) to consume health care in another Member State (Belgium and Germany). The familiarity with (health care in) Belgium eases the unofficial Decker and Kohll route. However, when some parts of the health care services seem to be more expensive in the other Member State, the patient has to pay the difference. New court cases are pending before the European Court of Justice. These cases raise new issues such as the tenability of 'benefits-in-kind' systems. So far, the Decker and Kohll rulings could be seen as an incentive to enhance access to cross-border health care in border areas.

Europe 1992: conflicts between European law and national health law.

In this article conflicts between European law and national health law are discussed. National laws are no longer immune against the radical changes which are taking place within the European Community. National authorities also are not free to organize health care and develop health laws in their own countries without taking into consideration the consequences of the European legislation. Rules and regulations are needed for the organization and structure of health care, and health law regulations and directives are required. They have to contain stipulations to ensure, in the 'Europe Without Frontiers' expected after 1992, solidarity between the sick and the healthy, among age groups and income groups, in partnerships and regions with great and little demand for and the supply of health care services. For a consistent system of rules and regulations, a synthesis of the principles of European law and the principles of health law is indispensable.

[The effects of intensive care for newborn infants]. / De effecten van de intensieve zorg voor pasgeborenen.

This article is based upon a research project on behalf of the Dutch ministry of Welfare, Health and Cultural Affairs. It will give the reader an overview of the main effects of intensive-care neonatology mainly on the basis of a literature research. In this article medical, psycho-social, economic, legal and ethical effects have successively been investigated. The major findings from existing published work in the neonatal field are discussed, highlighting some of the unresolved issues. Finally, some conclusions are drawn and some suggestions for further research are made.

[Denturists and the Occupations in Individual Health Care Law]. / Tandprothetici in de Wet-BIG.

The legal position of denturists in the Netherlands will be discussed again in the near future. At the moment it is uncertain what the legal basis will be. It is important for denturists and other dental professionals to investigate the different possibilities in the legislation. Historical research and research of sources of law concerning the development of denturism learned that denturists have a lot of arguments to obtain a solid position in future legislation.

Cross-border alliances in health care: international co-operation between health insurers and providers in the Euregio Meuse-Rhine.

On behalf of the European Commission, a Cross-Border Health Care Project was undertaken to explore how citizens living in the Euregio Meuse-Rhine can obtain improved access to health services in the Member States concerned: Belgium, Germany, and The Netherlands. Main attention of the project is focused on practical issues of cross-border health care. The first results have shown that the new cross-border health alliances resulted in improved possibilities for patients to access more health care facilities than before. The creation of health care alliances could also be an example for future collaboration between the countries in Western, Central, and Eastern Europe. This paper also analyses the rights of patients on cross-border care in the Euregion.