WILLEMSTAD – The Social and Economic Council (SER) has raised serious concerns about the way healthcare tariffs are currently being set on Curaçao, while also pointing to delays in the legislative process surrounding the Curaçao Health Authority (CZA). These issues are outlined in a recently published advisory opinion on a draft national decree regulating laboratory diagnostics.
In its advice, the SER notes that it had been announced that legislation establishing the CZA would be submitted to the Curaçao Parliament by December 2025. That has not yet happened. Despite the absence of a formal legal basis, the Curaçao Health Authority in formation (CZA i.o.) has already begun operating in practice.
According to the SER, the draft decree on laboratory diagnostics is problematic because it does not have a temporary character. This runs counter to earlier agreements with laboratories, which had accepted interim pricing arrangements on the condition that they would remain temporary until the CZA i.o. completed its own cost analyses and a formal legal framework was in place.
Although not yet formally anchored in law, the CZA i.o. has already been commissioned by the Ministry of Health, Environment and Nature (GMN) to carry out cost studies aimed at determining healthcare tariffs. The SER reports that four such studies have been completed so far, focusing on cost structures, efficiency, and tariff models within different healthcare services. For 2026, an additional cost study is planned for nursing homes, elderly care facilities, and home care providers, a sector that includes nine active organizations.
The advisory council notes that the CZA i.o. is working closely with the Dutch Healthcare Authority (NZa), aligning methodologies where possible and incorporating international standards, including guidelines on geographic accessibility of healthcare services. The outcomes of the cost studies are intended to be translated into formal advice to the GMN minister. In line with NZa practice, the CZA i.o. aims to review tariffs periodically, typically every 24 months, with indexation proposals included as a standard element.
The SER stresses that regular indexation of healthcare tariffs is essential to ensure cost-covering prices over time, even though such indexation has historically been uncommon on Curaçao. To safeguard the reliability of cost studies, agreements have been made with the Social Insurance Bank (SVB) requiring that at least two-thirds of providers within a sector submit financial data before tariffs can be established.
This requirement, the SER notes, has not been met in the case of laboratory diagnostics. Only two laboratories provided cost data, which the council considers insufficient to produce representative and transparent tariffs. In addition, the SER criticizes the lack of a clear economic justification for the proposed pricing, arguing that tariff calculations should be supported by up-to-date, verifiable, and broadly understandable economic data.
The SER concludes that without full participation by providers and a solid legal framework for the CZA, the current approach to healthcare tariff setting risks undermining transparency, trust, and long-term sustainability within Curaçao’s healthcare system.