(Bloomberg) — The Dutch government coalition of the Liberal VVD and Labor parties continued talks today in an effort to save a health-care bill and stave off a cabinet crisis.

A bill to give health insurers more power to pick health-care providers failed to get a majority late yesterday in the upper house of parliament after three Labor senators unexpectedly voted against it. The measure would save the government about 1 billion euros ($1.25 billion).

The health-care bill is part of a larger deal on health reached by the government with three opposition parties — D66, the Christian Union and the SGP Reform Protestants. Prime Minister Mark Rutte’s coalition needs support from opposition parties in the Senate as it lacks a majority in the upper house.

“It’s important that we live up to the agreements we make together in politics,” Rutte said early this morning. “On that point something went clearly wrong today.”

See also: Dutch View CI Policies As Income Protection.

Health insurers in the Netherlands can now sell indemnity policies that let enrollees see any provider who is willing to accept the Dutch equivalent of a reasonable and customary fee. Dutch companies can also sell “natura” plans, or health care services agreement plans, that give enrollees access to the providers who have agreed to participate in the plan provider network.

Under current Dutch laws based on a European insurance law framework, the health care services plan managers can impose penalties on enrollees who get out-of-network care, but not penalties high enough to create an obstacle to use of care. Dutch authorities have held that health care service plans must pay 75 percent of the cost of out-of-network care.

The proposal now being debated would let an insurer choose its own level of reimbursement for out-of-network care, or decline to pay for out-of-network specialist care. Enrollees would still have a right to get full compensation for out-of-network specialist care if the plan failed to provide the necessary care within a reasonable distance and a reasonable period of time, according to Edith Schippers, the Dutch health minister

Supporters argue the proposal would help hold down the cost of care. Critics say it could interfere with patients’ access to care.

 

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