There is a considerable interest in some OECD countries in understanding how greater choice in health markets can be combined with the equity and efficiency goals of health systems.

This paper reviews the system of free choice of insurer in basic mandatory health insurance that was introduced in Switzerland with the 1994 Health Insurance Law (LAMal). The thrust of the reform was to increase solidarity in basic health insurance while enhancing choice among individuals and competition on quality-price ratios among insurers. The reform encompassed regulatory mechanisms to facilitate the switching mechanism and choice-led competition, such as measures to ensure cross-subsidisation across individuals of different risk and income, information disclosure requirements for insurers, and the mandatory participation to a risk equalisation mechanism for all insurers offering basic health insurance.

The analysis presented in this paper suggests that some features of the individual choice ...

Certains pays de l'OCDE manifestent un très grand intérêt à comprendre comment un plus grand choix sur les marchés de la santé peut aller de pair avec des objectifs d'efficacité et d'efficience des systèmes de santé.

Ce rapport examine le système de libre choix du fournisseur de l'assurance-maladie de base obligatoire qui a été introduite en Suisse avec la loi sur l'assurance-maladie de 1994 (LAMal). Le but de la réforme était d'augmenter la solidarité de l'assurance-maladie de base tout en offrant un plus large choix à chaque individu ainsi qu'une concurrence au niveau qualité/prix parmi les assureurs. La réforme englobait des dispositifs régulatoires pour faciliter le mécanisme de changement ainsi que les mesures pour assurer un échange de subvention parmi les individus ayant des niveaux de risques et de revenus différents, des besoins en transparence d'informations pour les assureurs et la participation obligatoire dans un mécanisme d'égalité des risques pour tout assureur ...

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Paper provided by OECD Directorate for Employment, Labour and Social Affairs in its series OECD Labour Market and Social Policy Occasional Papers with number 53.

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Date of creation: 18 Sep 2001
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Handle: RePEc:oec:elsaaa:53-en

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1. Mark Pearson & John P. Martin, 2005. "Should We Extend the Role of Private Social Expenditure?," IZA Discussion Papers 1544, Institute for the Study of Labor (IZA). [Downloadable!]
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   • Mark Pearson & John P. Martin, 2005. "Should We Extend the Role of Private Social Expenditure?," OECD Social Employment and Migration Working Papers 23, OECD Directorate for Employment, Labour and Social Affairs. [Downloadable!]

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