By René Zwart ©

The Hague – Sterilization for both men and women will be reimbursed in the Caribbean Netherlands from 1 January by the BES Healthcare Insurance Office. This is shown by the Insured Monitor that Minister for Medical Care Bruno Bruins published.

The reason for the decision is the high abortion rate. On Bonaire, St. Eustatius and Saba, half of the 450 pregnancies are terminated prematurely. Of the group of women who undergo an abortion, a large proportion, more than 30 percent, have a complete family. It is expected that by reimbursing sterilization the number of unplanned pregnancies decreases. In the Netherlands it is possible to take out supplementary insurance for sterilization. Inhabitants of the Caribbean Netherlands do not have this option. More changes are being made:

• The inclusion of supervised exercise therapy with COPD will from now on be reimbursed from the first treatment. That is only now from the 21st year of life. In addition, just as for the basic package in the European Netherlands, the entitlement to patient transport other than by ambulance is extended. As of 2019, the entitlement is no longer limited to transport in connection with oncological treatment or the undergoing of kidney dialysis, but also includes consultations, examinations and checks that are necessary for oncology treatments and kidney dialysis.

• The entitlement to reimbursement of pharmaceutical care is also supplemented. In order to qualify for reimbursement, the pharmaceutical care must have been prescribed by a treating physician, dentist or midwife. Dietary preparations are part of pharmaceutical care for a certain category of insured persons. In practice, these insured persons are also treated by dietitians, who also prescribe dietary preparations. For this reason, the claim has been supplemented, so that dieticians can also prescribe dietary preparations from 1 January.

• The personal contributions for orthopedic footwear and allergen shoes have been determined in the past on the basis of the Dutch amounts. It turned out that these own contributions can not be collected because the capacity of the inhabitants of the Caribbean Netherlands is not sufficient enough. That is why the personal contributions for orthopedic footwear and allergen shoes are reduced to amounts that are in line with the capacity of the insured and are actually collectable.

• The claim for repatriation of the territory outside the BES islands has been adjusted. From this claim it is possible in the event of death outside the BES islands to reimburse repatriation of the mortal remains to the former place of residence. However, this would mean that if, for example, a resident dies on Saba, while his residential island is Bonaire, repatriation of his mortal remains would not be compensated because the resident has not died outside the territory of the BES islands. This was not the intention of the legislator at the time and has been adapted for this reason, so that repatriation between the BES islands is also reimbursed.

• Finally, a clarification has been made about the entitlement to GP care. At the moment it is arranged that the general practitioner care does not include medical examinations. In practice, however, it appears that the GP is asked to assess the disability of their own patient. This is undesirable because there must be a relationship of trust between the general practitioner and his patient. For that reason, it is explicitly stated that incapacity for work does not fall under general practice care.