24 February 2026
Income solidarity in the Dutch Health Insurance Act (Zvw) remained relatively stable between 2012 and 2019 despite some policy changes. During this period, solidarity was slightly regressive: middle incomes contributed relatively the most to the Zvw, while higher incomes contributed the least. Policy changes, such as the increase in the deductible in 2013 and the reduction of the healthcare allowance in 2014, had only limited or temporary effects on the distribution of the burden.
Income solidarity is an important principle in financing the Zvw, but how it has recently developed has not been mapped before. In our study, we investigate the income solidarity of the different financing streams of the Zvw from 2012 to 2019. We build on an earlier CPB analysis that mapped income solidarity in 2019 and show how income solidarity developed over the years in relation to policy changes.
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