While the political debate on healthcare mainly focusses on costs, Social Finance NL, Rabobank and Invest-NL highlight how innovative investment in prevention is key to a future-proof healthcare system in a new report. The system is straining under pressure: staff shortages and healthcare expenditures continue to rise, yet only a fraction of the healthcare budget is spent on preventing illness. In 2024, only 5 percent (€6 billion) of the more than €113 billion spent on Dutch healthcare went to prevention. The impact report 'Innovative Financing for Prevention' calls for new financial rules in the sector. The report, written by Social Finance NL, gives three concrete recommendations to organise the financing, governance and accountability of prevention more effectively.
Only one in twenty euros goes to prevention
Dutch healthcare expenditures are among the highest in the EU, but investments in preventive health measures have lagged for years. Despite broad societal consensus on the importance of prevention, structurally investing in preventive solutions remains a challenge. Of the more than €113 billion available for healthcare, only 5 percent (€6 billion) was spent on preventive care last year. This means that in 2024, only one out of every twenty euros in Dutch healthcare went to prevention. Although the Integrated Care Agreement ('Integraal Zorgakkoord') and the Healthy and Active Living Agreement ('Gezond en Actief Leven Akkoord') highlight the importance of prevention, the current financing structures hinder its sustainable implementation. Ruben Koekoek, co-founder and managing director of Social Finance NL, together with Rabobank and Invest-NL, is calling for adjustments to healthcare financing.
Keeping healthcare affordable and accessible
Affordable and accessible healthcare
According to recent labour market forecasts in the Dutch healthcare sector, the shortage of healthcare workers will increase to 265,600 people by 2034. This is four times more than the shortage of workers in 2025.
The RIVM expects healthcare expenditures to exceed €200 billion by 2050, an increase of more than 76 percent compared to 2024. There is both momentum and urgency to give the healthcare system the resuscitation it desperately needs, says Koekoek: "To keep healthcare affordable and accessible for everyone, it is essential to get a grip on costs and the increasing staff shortage. Our extensive experience with outcome-based financing, Health Impact Bonds and Social Impact Bonds shows that investing in prevention pays off, because it reduces healthcare demand and lowers staff needs. This requires a redesign of financing, organisation and responsibility."
In the report 'Innovative Financing for Prevention', Social Finance NL joins forces with Rabobank and Invest-NL. "With concrete recommendations, we aim to help public and private parties transition from treating illness to investing in health," says Marleen Jansen, sector manager Healthcare at Rabobank. Examples include establishing regional health funds, creating a National Prevention Results Fund, and legally embedding prevention as an investment with national and local targets (for instance in a Health Act). "Many successful prevention initiatives fail to scale because structural financing for expansion is lacking. With this report, we aim to resolve that bottleneck: with new financing models, we can make proven prevention scalable and sustainably affordable," says Stanleyson Hato, team lead Life Sciences & Health at Invest-NL.
