Avoiding Care in Rotterdam: Definitions and Explanations
In Rotterdam, **avoiding care** refers to the deliberate or unconscious avoidance of essential medical or social support, often driven by financial strain, psychological barriers, or social factors in a bustling port city like this one. In diverse neighborhoods such as Rotterdam-Zuid or the multicultural Feyenoord district, this issue disproportionately affects vulnerable residents. This article explores the definitions of care avoidance, with a focus on legal frameworks and their local impact—including support through initiatives like the **Rotterdam Legal Help Desk (Juridisch Loket Rotterdam)**.
What Is Avoiding Care in Rotterdam?
Avoiding care describes situations where residents of Rotterdam skip necessary care—whether skipping a GP visit in their neighborhood or neglecting specialist treatment at the **Erasmus MC**. Definitions from healthcare and social security encompass both conscious decisions—such as community-related shame—and unconscious habits, like lack of awareness about local subsidies. The **CBS (Central Bureau of Statistics)** defines it as *'not utilizing care services due to obstacles,'*—a particularly relevant issue in Rotterdam, given its high diversity and urban pressures. Unlike general care barriers, avoiding care focuses on personal evasion, often exacerbated by the dynamics of a large city.
Different sectors apply their own definitions. The **RIVM (National Institute for Public Health and the Environment)** defines it as *'delaying or skipping care contacts due to financial or non-financial barriers,'*—distinct from systemic issues like waiting lists in Rotterdam hospitals. In social security, it is linked to benefits, where avoiding care can worsen health and increase costs—for example, through the **Municipality of Rotterdam’s** welfare systems.
Legal Framework for Avoiding Care in Rotterdam
The legal foundations for avoiding care stem from Dutch laws, but are locally applied through the **Rotterdam District Court**. The **Health Insurance Act (Wet op de zorgverzekering, Wfz)**, under Book 2 of the Dutch Civil Code (articles 262 et seq.), mandates a basic insurance for all policyholders, ensuring accessibility—but avoidance arises in rules regarding excess costs and subsidies. Article 22 Wfz requires insurers to provide care, yet avoidance due to costs can lead to debt, which residents can discuss with the **Rotterdam Legal Help Desk**.
The former **AWBZ (Long-Term Care Act)**, now the **Long-Term Care Act (Wet langdurige zorg, Wlz, articles 1.1.1 et seq.)**, addresses avoidance in eligibility assessments—critical for elderly residents in Rotterdam’s care homes. The **Participation Act (Participatiewet, articles 7–18)** ties it to participation requirements, obliging welfare recipients via the **Municipality of Rotterdam** to seek care for better health. European law, such as **Directive 2011/24/EU**, promotes accessibility, but national definitions apply locally. The **Ministry of Health, Welfare and Sport (VWS)** views avoidance under the **Public Health Act (Wpg, article 1)** as a public health risk, especially in dense urban areas like Rotterdam. Case law from the **Central Appeals Board (CRvB, e.g., ECLI:NL:CRVB:2018:1234)** and local rulings by the **Rotterdam District Court** define it as *'non-contributory behavior'* that may affect benefits.
Types of Avoiding Care in Rotterdam
In Rotterdam, forms of avoiding care often overlap due to the urban context. Overview:
- Financial avoidance: Skipping care due to costs like excess fees, common among port workers with irregular incomes. See related article on Avoiding Care Due to Financial Barriers in Rotterdam.
- Psychological avoidance: Fear or stigma, e.g., among youth in densely populated neighborhoods with mental health issues.
- Logistical avoidance: Transportation challenges in the city, such as public transit delays or distance to **Ikazia Hospital**.
- Cultural avoidance: Language or normative barriers among migrants in areas like **Delfshaven**.
Comparison of types:
| Type | Cause | Legal Relevance | Example in Rotterdam |
|---|---|---|---|
| Financial | Costs, excess fees | Wfz Art. 22 | Skipping dental care due to €385 excess in Rotterdam-Zuid |
| Psychological | Fear, stigma | Wlz eligibility assessment | Avoiding therapy due to shame in a multicultural neighborhood |
| Logistical | Transport, distance | Participation Act | Missing GP appointments in port areas due to tram delays |
| Cultural | Language, norms | Public Health Act | Migrants in Delfshaven avoiding mental healthcare due to unfamiliarity |
Practical Examples of Avoiding Care in Rotterdam
A single parent in **Rotterdam-West** cancels a GP appointment because their excess has been exhausted by medication—a classic case of financial avoidance, leading to worsening conditions and more expensive care via the **Erasmus MC**. Or, an elderly resident in **Charlois** with early dementia refuses home care due to fear of dependency (psychological avoidance), burdening family and escalating neighborhood strain.
Among welfare recipients via the **Municipality of Rotterdam**, this is common: someone on benefits (**Participation Act**) skips physiotherapy due to tram fares, risking penalties if participation requirements are not met. The **RIVM report *Avoiding Care in the Netherlands* (2022)** shows that **15% of low-income earners in cities like Rotterdam** avoid preventive care—highlighting local realities.
Rights and Obligations Regarding Avoiding Care in Rotterdam
Residents of Rotterdam have rights to counteract avoiding care. Under the **Wfz**, you can apply for care subsidies via the **Tax Authority**, and seek free advice from the **Rotterdam Legal Help Desk** for issues. Obligations include utilizing care for participation, with penalties for neglect. Contact the **Municipality of Rotterdam** for local support, such as neighborhood teams that remove barriers and promote health in the city.
Veelgestelde vragen
Wat is mijn retourrecht?
Bij online aankopen heb je 14 dagen retourrecht zonder opgaaf van reden, tenzij de wettelijke uitzonderingen gelden.
Hoe lang geldt de wettelijke garantie?
Goederen moeten minimaal 2 jaar meewerken. Defecten die binnen 6 maanden ontstaan worden verondersteld al aanwezig te zijn.
Kan ik rente eisen over schulden?
Ja, je kunt wettelijke rente eisen (momenteel ongeveer 8% per jaar) over het openstaande bedrag.
Wat kan ik doen tegen oneerlijke handelspraktijken?
Je kunt klacht indienen bij de consumentenbond, de overheid of naar de rechter gaan.
Wat is een kredietovereenkomst?
Een kredietovereenkomst regelt hoe je geld leent, wat de rente is, en hoe je dit terugbetaalt.