The two largest Dutch insurers have signed contracts with big private healthcare providers in Germany where they say healthcare is often cheaper and more effective than in the Netherlands. And the scale of healthcare tourism in the Netherlands could escalate if the government hands over the financing of the care sector to statutory insurers in 2012.

Uvit, an amalgamation of four big Dutch healthcare insurers has signed contracts with Helios and Median. Spokesman Dennis Verschuren said that Median would be carrying out knee and hip replacements and that the German treatment included a five week stay in a rehabilitation unit where the patients will get intensive physiotherapy and coaching. He said that this cost broadly the same as the Dutch treatment where the patient goes home after the op and then visits the physio as an outpatient for the following 20 weeks. He added: “One thing is sure after five weeks the patient in Germany will be much further advanced.” The contract with Helios is open ended and covers all operations.

Achmea, the largest Dutch insurer also sends patients to Germany. Maartin Boon, whose company HollandIntercare arranges treatment for Agis, now part of the Achmea group, says it is far cheaper in Germany.

So far numbers are not huge. The Median contract is for 100 patients a year – around 2% of Uvit’s annual hip and knee replacements. Verschuren said: “This is not about price, but about offering patients the care they want where they want it. If queues are long in the Netherlands we can offer them Germany.”

Boon says it is estimated by the Health Insurance College of the Netherlands (CVZ.nl) that 1% of medical care for Dutch people takes place abroad. He says that many Achmea patients want treatment in their home country, others fancy going somewhere hot like the Caribbean to recuperate and some want to see foreign specialists.

He argues that healthcare tourism is likely to soar if the Dutch government decides to move the cost of care for the elderly to the statutory mutual insurers, who took over acute care from the Dutch state some two years ago. He said it looks likely that such a move will happen in 2012. “The insurers have demonstrated that they are better at cost control than the government and they have made a success of acute. The care budget is huge and rising by 8% a year. If it were to move to the insurers, I would expect to see a big increase in healthcare tourism as individuals opt for to be looked after abroad for some of the year.”