Background Dutch arthritis patients, who need physical therapy care, have been severely limited in available health insurance options between 2012 and 2014. Due to a lack of scientific evidence concerning long-term physiotherapy and arthritis, the economic crisis and steeply increasing healthcare costs in the Netherlands, the national government removed the reimbursement of physical therapy care for arthritis patients from the standard healthcare plan to private supplemental healthcare plans in 2012. Consequently, private Dutch health insurers do not only determine the prices and contents of their supplemental healthcare plans since 2012, but also if arthritis patients get access to the number of physiotherapy treatments covered by their plans.
Objectives The Dutch Arthritis Foundation finds that arthritis patients must be able to access necessary physical therapy care. Therefore, we have applied several advocacy strategies to influence the public, media and the main governmental, political and private stakeholders.
Methods In 2012, nearly 4,600 arthritis patients participated in an online registration point, which we had opened for lodging problems and complaints regarding the accessibility of physical therapy care in private healthcare plans. After six months, a follow-up enquiry was done among the participants. In July 2012, we published the results and presented them to national media, as well as the national government and parliament.
Every year in December, Dutch citizens can opt to change their healthcare insurer and plans. In 2012, we published a comparison on our website, listing 33 “arthritis-friendly” supplemental healthcare plans. These plans reimbursed an unlimited amount of physiotherapy treatments and were accessible without any medical restrictions. One year later, our comparison showed that the number of supplemental plans had dropped to 11, 1% of all plans. We immediately sent a letter to the Minister of Health, the parliament, health insurers and national media, fearing that arthritis patients were about to fall between the cracks of the Dutch healthcare system in 2014.
Results We have achieved several successes in our awareness campaign and advocacy for physiotherapy recently. Most stakeholders acknowledge now that constraining access to physical therapy care not only has consequences for arthritis patients, but has social and economic impact as well. For instance, the use of hospital care has increased, as well as absenteeism from work and disability allowances. Following much media attention, Members of Parliament have asked the Minister of Health to find a solution for arthritis patients regarding access to physical therapy care. Hence, a government body is now looking at enabling access to physical therapy care for arthritis patients with high disease activity and joint damage. In summer 2014, the minister of Health will decide on returning physical therapy care for this specific group to the standard healthcare plan.
Conclusions Over the last two years, we have learned a lot about patient advocacy in a changing and increasingly more difficult Dutch healthcare system with private players and governmental decision-making. We were able to increase awareness for arthritis patients, and we will continue our efforts to find a long-term solution that benefits those patients who need regular physiotherapy to live their daily lives.
Disclosure of Interest None declared