WILLEMSTAD – The introduction of a health levy and fair, income-based co-payments is inevitable if Curaçao is to make its healthcare system sustainable for the future, according to the Central Bank of Curaçao and Sint Maarten (CBCS). 

In a report published this week on the long-term viability of the island’s healthcare system, the CBCS warns that without reform, rising healthcare costs will put severe pressure on public finances. The measures, the Bank says, would broaden the system’s revenue base and help absorb the impact of an aging population. 

Costs Projected to Surge by 2050 

The report projects that, driven largely by demographic aging, Curaçao’s annual healthcare expenditure will rise by more than 140% by 2050 if no action is taken. While prevention and attracting working migrants can help, the CBCS stresses that structural financing reforms are essential. 

Two key measures are proposed: 

A fixed health levy, potentially collected through the tax system; 

Income-based co-payments that reflect both the user’s ability to pay and their use of healthcare services. 

Revenue Potential 

A 1% health levy on gross income could generate approximately 45 million guilders per year — enough to partially offset future spending increases. An average income-based co-payment of 100 guilders per user per year, with certain exemptions, could add between 10 and 15 million guilders annually. 

International Precedents 

The CBCS cites examples from Europe and the Caribbean, where similar systems have provided more stable healthcare financing while maintaining access to care. 

Such a reform in Curaçao, the report concludes, would create a fairer and more resilient healthcare system — provided all revenues are fully allocated to the health sector.