When Policy Meets the Rule of Law

More Than a Healthcare Dispute

During more than two decades of practicing law throughout the Dutch Caribbean, I have learned that the most important constitutional cases rarely announce themselves as such. They seldom involve dramatic headlines or sweeping constitutional reforms. More often, they arrive disguised as ordinary administrative disputes, a permit denied, a license refused, a government contract challenged or, as in this case, a disagreement over a healthcare reimbursement code.

At first glance, the recent judgment of the Court of First Instance of Curaçao involving the Sociale Verzekeringsbank (SVB) and Lab de Med appears to concern little more than the reimbursement of a thrombosis service. Many readers would understandably conclude that this is a matter for lawyers, doctors and healthcare administrators.

It is not.

It is about something far more fundamental. It is about the limits of public power and the enduring principle that every government authority, no matter how important its mission, must remain within the powers entrusted to it by the legislature. The Court's judgment is therefore significant not because it determines healthcare policy, but because it reaffirms one of the cornerstones of the rule of law: public institutions may exercise only the authority the law has given them.

The Question the Court Actually Answered

One of the most interesting aspects of this judgment is not what the Court decided, but what it deliberately refused to decide.

The Court did not determine whether Curaçao should have one thrombosis service or several. It did not decide whether concentrating those services with a single provider is good healthcare policy. Nor did it express a preference for one laboratory over another. Those are policy decisions, and rightly so.

Instead, the Court asked a far simpler question: where, in the law, does the SVB derive the authority to grant an exclusive reimbursement code to one approved healthcare provider while denying it to another?

After carefully examining the applicable legislation, the Court concluded that the legal basis relied upon by the SVB did not support the distinction it sought to make. The decision was therefore annulled, for the second time, and the SVB was directed to reconsider its position within the confines of the law.

That distinction is critical because it reminds us that the rule of law does not depend upon whether a policy appears sensible or efficient. It depends upon whether the authority exercising public power has the legal authority to do so.

Another aspect of this case makes the judgment particularly noteworthy. This was not the first time the Court had told the SVB that the legal basis upon which it sought to maintain this distinction was insufficient. As we can see from this decision, in December 2025, the Court had already rejected the legal basis then relied upon by SVB and ordered it to reconsider. No appeal was filed against that judgment, and it therefore became final. The SVB subsequently returned with a different legal justification for essentially the same outcome, and the Court has now concluded that this legal basis does not provide the claimed authority either.

This brings us to an uncomfortable but necessary question. When a public authority has already been told that the law does not provide the power it claims, at what point should it stop searching for another legal justification to maintain the same outcome and instead ask whether the outcome itself needs to change? That is not a criticism of any public authority's right to defend its position. It is a question of institutional restraint and, ultimately, of respect for the rule of law.

Good Policy Does Not Create Legal Authority

No one disputes that healthcare presents enormous challenges. Costs continue to rise, demand increases every year, and governments across our region struggle to balance affordability with accessibility and quality. Institutions such as the SVB carry significant responsibilities, and few would envy the difficult decisions they must make.

But difficult decisions do not enlarge statutory powers.

One of the greatest temptations facing any public institution is to assume that because a particular policy appears desirable, the law must somehow permit it. Yet that is not how constitutional government works.

The law gives government its authority. It also defines its limits. Public institutions cannot create new powers simply because existing powers prove inconvenient or because a particular policy objective appears worthy. Every exercise of public authority must ultimately be traceable to legislation enacted by Parliament. Otherwise, today's policy becomes tomorrow's administrative practice, tomorrow's practice becomes accepted custom, and accepted custom slowly begins to masquerade as law.

That is precisely what constitutional safeguards are designed to prevent.

The Importance of Institutional Restraint

If my years in practice have taught me anything, it is this: public institutions rarely exceed their powers because of bad intentions. More often, it happens gradually.

An administrative practice develops because it appears practical. Over time, that practice becomes routine. Eventually, what began as a practical solution is treated as though it were the law itself. That is when someone must stop and ask the most fundamental question of all: do we actually have the legal authority to do this?

That question lies at the very heart of judicial review.

Courts are not policymakers. Their constitutional role is far more fundamental. They ensure that those entrusted with public power remain within the authority granted to them by law. In this case, that is precisely what the Court did. It did not substitute its own healthcare policy for the SVB's. It simply reminded the SVB that however legitimate its policy objectives may be, those objectives cannot replace statutory authority.

Why This Matters to Every Citizen

Some readers may still wonder why this dispute matters to them. The answer reaches far beyond healthcare.

Today, the issue concerns a healthcare reimbursement code. Tomorrow, it may concern licensing, taxation, education, immigration, public procurement, or any other area in which government exercises public power. The constitutional principle, however, never changes. Whenever government acts, it must first answer one fundamental question: What authority does the law provide? Not what appears sensible, not what has always been done, not what is administratively convenient, and not even what may appear to serve the public interest, but what the legislature has actually authorized. That simple question is one of the most important safeguards of individual liberty because it protects every citizen equally from the arbitrary exercise of public power.

Patients Benefit from the Rule of Law

It is easy to lose sight of the people who matter most in disputes such as these. The patient.

Healthcare providers, whether public or private, are not adversaries competing for control of the healthcare system. They are participants in a common mission. Patients benefit when qualified healthcare providers can contribute their expertise within a legal framework that is transparent, predictable, and fair. They benefit from innovation, timely access to care, and confidence that public decisions are made in accordance with the law rather than administrative preference.

The rule of law is therefore not an abstract concept reserved for lawyers and judges. It is a practical safeguard that protects the integrity of the healthcare system itself and, ultimately, the people it exists to serve.

A Lesson for the Caribbean Parts of the Kingdom

Although this judgment was delivered in Curaçao, its significance extends beyond its shores.

Across the Caribbean parts of the Kingdom, public healthcare authorities face similar pressures: rising costs, increasing demand and limited budgets. Those challenges are genuine, and they deserve thoughtful responses from policymakers. Yet difficult circumstances never justify expanding public authority beyond what the law permits. If anything, they demand greater discipline. The rule of law is tested most rigorously where public power is most concentrated.

That is a lesson worth remembering, not only in Curaçao, but throughout our Dutch Caribbean.

The Real Winner

It would be easy to describe this judgment as a victory for one laboratory and a defeat for the SVB. I believe that would miss the point entirely. The real winner is the constitutional principle that government exists under the law, not above it.

Public institutions perform indispensable functions and deserve our respect. But that respect is strengthened, not diminished, when those institutions are held accountable to the legal limits established by Parliament. Far from weakening government, judicial oversight reinforces public confidence that power is exercised fairly, transparently and according to law.

Governments change. Policies evolve. Institutions adapt. Yet one principle must remain constant: public power exists because the law creates it, and it ends where the law says it ends. The day we allow good intentions to replace legal authority is the day we begin to weaken the very foundation of democratic government.

That is why this judgment matters. It is not simply about a laboratory or a reimbursement code. It is a timely reminder that in a society governed by the rule of law, no public institution, regardless of how important its mission, may exercise powers that the legislature has not granted. That principle protects all of us, and it is one worth defending.

Thank you for reading. I look forward to seeing you again next week.

In the meantime, www.lincolngomez.com has been rebuilt. Every blog, article, and column I have published since 2007 now sits in a single register, in Dutch, English, Papiamento, and Spanish, gathered into nine dossiers that can be read in the order in which the argument develops. My books are listed there as well.

Until then, stay informed, stay engaged, and never underestimate the enduring importance of the rule of law