Traditionally the welfare state has a larger extend in Dutch society than in the US. Long-term care (like nursing homes and care homes) and support (like home care and adjustments to homes) are part of the public domain, meaning the coverage and the costs are determined by government and are equally accessible for all citizens. People pay a co-payment based on their income. The remainder of the costs is paid by a government fund. This fund comes from earmarked income tax and is a pay-as-you-go system.
The aging of western societies and the economic downturn put pressure on collective burdens. The costs of long-term care and support services rise every year; in the last decade the average increase was 6.8 percent a year. This number in retrospect is quite worrisome, given the fact that the post-world war II generation is retiring from the year 2011 onward. Therefore the genuine growth is yet to come. The Dutch government is redesigning the long-term care and support services due to the expected rise of costs, where the corresponding increase in tax euros puts pressure on an economy in recovery and on the growing need for inter-generational solidarity.
One of the policy changes is that public services are not the first option for providing care or support, rather it is the informal caregiver. To accommodate this shift, payment for care therefore is no longer non-competing health insurers, but the municipalities. The latter can better be established if someone’s social network can be part of someone’s care.
Positive perspectives in society
Some members of society may view the additional responsibilities for patients, spouses, their children and/or other informal carers as a burden, or to allow the persons condition to deteriorate merely to save costs. But this is too simplistic. Those who advocate for more tailor made care and less centralized rules can advance this discussion to include rebalancing of responsibilities in society so as to reinforce the current level of solidarity between income groups, generations and the unfortunate. When the increase in demand in care is viewed only from the lens of formal care, the net payers to society will face a fast growing bill and this can erode the support for solidarity.
We learn from dialogue with our members that, if asked, people are definitely willing to do something extra for their loved ones, neighbors or even strangers. We sometimes complain on the focus on the ‘me’ in society, but there is great potential of informal support and reciprocity within neighborhoods. The fundamental premise of AARP’s ‘Create the Good’ is the fact that 40 percent of all citizens are prepared to do something for their fellow citizens, if they knew what and when. This is also the case in The Netherlands: “I would like to help, but often I am not aware who is in need.”Therefore we address two essential questions to make our society a more caring society that can face the challenges of the future:
(1) can we change the mentality which, when someone is in need of care, it is not automatically assumed to be only the government’s responsibility? and
(2) can we help people to help others; there is potential, but how do we unlock this large amount of social capital?
A tool that is a gift to society
PGGM pondered this question. How can we help people to help each other? Together with Rabobank and health insurer CZ we established a new venture: WeHelp (in Dutch WeHelpen). An online tool, via eBay - not for goods but for the exchange of social capital. People can post their questions (like: who can take me to hospital for an appointment?; or who can help with the groceries?) and people can offer help (and can give a timeframe). The online matchmaking is easy and can be filtered by relevance (what service?) and location (where?). It is also possible to create ‘help circles’, so that your requests are only seen by people you’ve selected to view your request. WeHelp also offers an agenda (easy to plan for the carers) and a logbook (exchange information between the carers). The tool was launched October 30th last year. The venture is a cooperative and the members are municipalities and health institutes. They can offer the tool to their citizens or patients and their families. WeHelp can help the members of the cooperative implement the system in their areas. The business model is that the members share the costs and therefore we see that future membership tariff drop when membership grows. What helped is that all four large health insurers joined the cooperative before the launch, paying the largest part of the costs.
WeHelp is about getting accustomed to using modern tools for civil society. This takes time, because people are used to the manner that it is primarily a public task to take care for the people in need. But this is not a sustainable approach in an aging society. WeHelp can help the necessary transformation of a caring society in The Netherlands.
About the author
FRIDO KRAANEN is the Director of Cooperative and Corporate Sustainability (CSR) at PGGM. PGGM is a pension service provider for the health care and social services sector in The Netherlands. PGGM is not only focusing on pension, but acknowledge that a good old day needs a wider perspective. Frido is working on this strategic re-orientation of the organization. He is also responsible for the company’s cooperative principles, the societal agenda of PGGM and the corporate social responsibility program. He is also a board member of the Cooperative WeHelp.
Before Frido joined PGGM he worked for the Netherlands’ Ministry of Health care, Welfare and Sports, lately as a deputy director for Macroeconomic policy and Labor relations. Besides that he was the Netherlands’ delegate and council member of the Health Committee of the OECD.
Source: AARP The Journal