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Dialogic, together with Significant Public, conducted an evaluation of the tax deduction for specific healthcare costs (hereinafter referred to as the 'specific healthcare costs scheme') and the 'Compensation for Specific Healthcare Costs' scheme (hereinafter referred to as the 'CSHC scheme'). Through the specific healthcare costs scheme, it is possible to deduct specific healthcare costs in the tax return under certain conditions. Costs for medication and aids are among those eligible. In 2019, over 850,000 households made use of the specific healthcare costs scheme, with a budgetary impact of nearly €270 million. The CSHC scheme compensates those who receive less tax relief due to the deduction of specific healthcare costs. In 2019, almost 230,000 taxpayers benefited from the CSHC scheme, with a budgetary impact of over €65 million. The research involves existing studies on the specific healthcare costs scheme, interviews with client organizations, analysis of tax return data, a survey among the Dutch population, and information from the Tax Authority regarding the implementation of the scheme.
Our conclusion is that when we focus solely on the specific healthcare costs scheme itself, it appears to be an effective instrument. The target group for which the scheme is intended is using it and/or aware of its existence. However, when looking at the broader aim of the scheme (providing compensation for extra costs), its effectiveness is limited. This is partly due to certain healthcare costs being excluded and the presence of a threshold. As a result, some individuals with chronic illnesses or disabilities incurring extra healthcare costs are not eligible. For the CSHC scheme, it can be stated that the instrument itself is inherently effective. If a user is entitled to it based on their tax return, the Tax Authority automatically calculates it. However, the user must file a tax return, which does not always happen. It is just not possible to specify how often this occurs.
