Why Netherlands hospital prices are lower
Netherlands sets one hospital price — a DRG, a tariff, or a budget. The hospital takes it. It cannot charge each plan a different secret multiple. In the US the must-have hospital extracts 2–3× Medicare from job plans that cannot walk. The insurer passes that through. It does not set it.
NZa maximum prices
How it works
The Dutch Healthcare Authority (NZa) sets maximum prices. Hospitals bill DBC products inside those caps. Insurers are private and mandatory — they compete on service and networks, not on who hid a 3× contract.
Why it holds
A cap is a cap. You cannot ‘negotiate’ past the authority. That is the whole trick. Preference policies then shove volume to cheaper substitutes. The hospital still exists. It just cannot mint a US commercial multiple.
The invoices
See iFHP, RAND hospitals, Papanicolas.