Healthcare vs. defense: A crucial choice for the Netherlands

The Dutch budget is under pressure. While the defense budget is increasing, there's a notion to reallocate funds freed up by slowing healthcare spending. It seems like a technical debate, but it touches the core of our society: how do we value healthcare, and what do we mean by security?

The pressure on healthcare spending

The healthcare sector is structurally under strain. This is not only due to the aging population — the baby boomers now relying on care — but also because of financing rules that make the sector vulnerable.

Under the Solvency II regime, health insurers must meet capital requirements primarily designed for commercial insurers, not for social risk-sharing. These rules require health insurers to maintain large reserves, leaving billions of euros idle that could otherwise be used for innovation or prevention. Or even generate returns with the right choices!

On top of that, banks impose additional solvency requirements on health insurers — partly driven by the stricter Basel-III/IV guidelines — which restricts capital flow to where healthcare truly needs it. The irony is that we talk about "healthcare costs" while a significant portion of funds is tied up in financial securities that do not benefit the patient.

Aging population and the financing paradox

The baby boomer generation requires more care than any generation before them. This is not a choice, but biology. However, the political reflex is accounting-based: spend less on healthcare to create room elsewhere. But anyone who crunches the numbers will see that the healthcare system is only sustainable in the long term if healthcare productivity increases — not if budgets are cut. 

Defense spending: An understandable but costly priority

The reality of geopolitical threats justifies higher defense spending. The Netherlands has committed to the NATO standard of 2% of GDP, increasing to 3.5% by 2035. Yet, we must not forget that every euro invested in steel, ammunition, and infrastructure is a euro less for healthcare, humanity, and social cohesion. A strong military protects a country, but a healthy population is its foundation.

An alternative path: Investing in healthcare innovation

While defense focuses on hard power, healthcare can secure its future through smart technology and protocol innovation. The use of telemonitoring is an example of this. Patients are monitored at home, with sensors continuously recording vital signs. Only when an EWS (Early Warning Score) signal is triggered is a doctor alerted. This creates a system where the doctor acts only when necessary — not sooner, not later. This makes healthcare precision-driven rather than reactive and habitual.

Additionally, this calls for a revision of medical protocols: no longer static, but adaptive — shaped by synergy between doctor and algorithm. Technology observes, but the doctor interprets. Healthcare innovation is not a replacement for people, but an extension of human judgment. 

Financial and societal gains

Such a model structurally reduces healthcare pressure and makes the system financially healthier. The government can strengthen this movement by recalibrating the capital requirements of Solvency II based on societal value creation rather than just risk management. A system that recognizes investments in healthcare technology as risk reduction could free up billions of euros.

The same applies to the banking assessment of health insurers: banks currently assess solvency and liquidity, but hardly the societal return on investment. This could be the key to sustainable healthcare financing that fits the spirit of the times — not defensive, but forward-looking.

The Forgotten Reciprocity

There is a paradox in the current discussion. The generation that now needs care is the same generation that built up the Dutch economy. They bore the burdens of reconstruction, wage moderation, and taxes for public services from which we still benefit today. Now, at the end of their lives, their demand for care is seen by some as too expensive, too extensive, too inefficient.

This is troubling. Not only financially, but morally.

To disregard the contribution of the baby boomers is to pretend our prosperity arose spontaneously. The right question is not how much care they are still allowed to ask for, but how responsibly we handle it in a society they helped create.

Ethically, stripping care from this group is not a cost-cutting measure, but a form of historical amnesia. This does not mean everything should be unlimited — care must be efficient — but the underlying tone should be respect and reciprocity, not fatigue or economic shortsightedness.

From looking back to looking forward

True justice lies in finding a new balance: 
"a system that does not see the elderly as a cost, but as a source of experience, and where technology enhances human care rather than replaces it."

Healthcare should not be weighed against defense as if they are communicating vessels. The security of a society rests as much on weapons as on well-being.
A society that cares for its elderly maintains its moral compass — and that too is national security.

Conclusion: The balance of responsibility

The Netherlands stands at a generational crossroads. One generation defends our future, the other embodies our past. It is our task to build a worthy bridge between them.

Healthcare and defense are not rivals, but both expressions of responsibility. One protects the body of society, the other its soul. And it is this soul that demands we treat those who once built this country with care — not as a favor, but as a natural act of reciprocity.