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Swiss and Dutch “consumer-driven health care”: Ideal model or reality?

  • Okma, Kieke G.H.
  • Crivelli, Luca

This article addresses three topics. First, it reports on the international interest in the health care reforms of Switzerland and The Netherlands in the 1990s and early 2000s that operate under the label “managed competition” or “consumer-driven health care.” Second, the article reviews the behavior assumptions that make plausible the case for the model of “managed competition.” Third, it analyze the actual reform experience of Switzerland and Holland to assess to what extent they confirm the validity of those assumptions. The article concludes that there is a triple gap in understanding of those topics: a gap between the theoretical model of managed competition and the reforms as implemented in both Switzerland and The Netherlands; second, a gap between the expectations of policy-makers and the results of the reforms, and third, a gap between reform outcomes and the observations of external commentators that have embraced the reforms as the ultimate success of “consumer-driven health care.” The article concludes with a discussion of the implications of this “triple gap”.

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Article provided by Elsevier in its journal Health Policy.

Volume (Year): 109 (2013)
Issue (Month): 2 ()
Pages: 105-112

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Handle: RePEc:eee:hepoli:v:109:y:2013:i:2:p:105-112
Contact details of provider: Web page: http://www.elsevier.com/locate/healthpol

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  1. Richard Frank & Karine Lamiraud, 2008. "Choice, Price Competition and Complexity in Markets for Health Insurance," NBER Working Papers 13817, National Bureau of Economic Research, Inc.
  2. Lehmann, Hansjorg & Zweifel, Peter, 2004. "Innovation and risk selection in deregulated social health insurance," Journal of Health Economics, Elsevier, vol. 23(5), pages 997-1012, September.
  3. Beck, Konstantin & Trottmann, Maria & Zweifel, Peter, 2010. "Risk adjustment in health insurance and its long-term effectiveness," Journal of Health Economics, Elsevier, vol. 29(4), pages 489-498, July.
  4. Tuohy, Carolyn H., 2012. "Shall we dance? The intricate project of comparison in the study of health policy," Health Economics, Policy and Law, Cambridge University Press, vol. 7(01), pages 21-23, January.
  5. Maarse, Hans & Paulus, Aggie, 2011. "The politics of health-care reform in the Netherlands since 2006," Health Economics, Policy and Law, Cambridge University Press, vol. 6(01), pages 125-134, January.
  6. Smith, Peter C. & Anell, Anders & Busse, Reinhard & Crivelli, Luca & Healy, Judith & Lindahl, Anne Karin & Westert, Gert & Kene, Tobechukwu, 2012. "Leadership and governance in seven developed health systems," Health Policy, Elsevier, vol. 106(1), pages 37-49.
  7. Beck, Konstantin & Spycher, Stefan & Holly, Alberto & Gardiol, Lucien, 2003. "Risk adjustment in Switzerland," Health Policy, Elsevier, vol. 65(1), pages 63-74, July.
  8. Schut, Frederik T. & van de Ven, Wynand P. M. M., 2011. "Effects of purchaser competition in the Dutch health system: is the glass half full or half empty?," Health Economics, Policy and Law, Cambridge University Press, vol. 6(01), pages 109-123, January.
  9. Luca Crivelli & Massimo Filippini & Ilaria Mosca, 2006. "Federalism and regional health care expenditures: an empirical analysis for the Swiss cantons," Health Economics, John Wiley & Sons, Ltd., vol. 15(5), pages 535-541.
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