Rationing and competition in the Dutch health-care system
In this paper we examine the goals and effects of health-care policy in the Netherlands over the period 1980-2000. During this period Dutch health-care policy is marked by a peculiar combination of increasingly stringent cost-containment policies alongside a persistent pursuit of market-oriented reforms. The main goal of cost containment was to keep labour costs down under the restriction of universal equal access to health care. Supply and price control policies were quite successful in achieving cost containment, but in due course prolonged quantity rationing began to jeopardise universal physical access to health services. The main goal of market-oriented health-care reforms is to increase the system's efficiency and its responsiveness to patient's needs, while maintaining equal access. The feasibility of the reforms crucially hinges on the realisation of adequate methods of risk adjustment, product classification and quality measurement, an appropriate consumer information system and an effective competition policy. Realising these preconditions requires a lengthy and cautious implementation process. Although considerable progress has been made in setting the appropriate stage for regulated competition in Dutch health care, the role of the market is still limited. Copyright © 2005 John Wiley & Sons, Ltd.
Volume (Year): 14 (2005)
Issue (Month): S1 ()
|Contact details of provider:|| Web page: http://www3.interscience.wiley.com/cgi-bin/jhome/5749|
References listed on IDEAS
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
- Zeynep Or, 2002. "Improving the Performance of Health Care Systems: From Measures to Action (A Review of Experiences in Four OECD Countries)," OECD Labour Market and Social Policy Occasional Papers 57, OECD Publishing.
- Schut, Frederik T. & Hassink, Wolter H. J., 2002. "Managed competition and consumer price sensitivity in social health insurance," Journal of Health Economics, Elsevier, vol. 21(6), pages 1009-1029, November.
- W.B.F. Brouwer & F.T. Schut, 1999. "Priority care for employees: A blessing in disguise?," Health Economics, John Wiley & Sons, Ltd., vol. 8(1), pages 65-73.
- Van de ven, Wynand P.M.M. & Ellis, Randall P., 2000. "Risk adjustment in competitive health plan markets," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 14, pages 755-845 Elsevier.
- van de Ven, Wynand P.M.M. & Schut, Frederik T., 1994. "Should catastrophic risks be included in a regulated competitive health insurance market?," Social Science & Medicine, Elsevier, vol. 39(10), pages 1459-1472, November.
- Maarse, J. A. M., 1989. "Hospital budgeting in Holland: aspects, trends and effects," Health Policy, Elsevier, vol. 11(3), pages 257-276, June.
- Lamers, Leida M. & van Vliet, Rene C. J. A. & van de Ven, Wynand P. M. M., 2003. "Risk adjusted premium subsidies and risk sharing: key elements of the competitive sickness fund market in the Netherlands," Health Policy, Elsevier, vol. 65(1), pages 49-62, July.
- Paolucci, Francesco & Exter, Andre Den & De Ven, Wynand Van, 2006. "Solidarity in competitive health insurance markets: analysing the relevant EC legal framework," Health Economics, Policy and Law, Cambridge University Press, vol. 1(02), pages 107-126, April.
- Lieverdink, Harm & Maarse, Hans, 1995. "Negotiating fees for medical specialists in the Netherlands," Health Policy, Elsevier, vol. 31(2), pages 81-101, February.