The changing role of the state in the Dutch healthcare system
This paper deals with the changing role of the state in the Dutch healthcare system. At the eve of the first oil crisis the Netherlands had a relatively compound healthcare system combining several characteristics of the three Western healthcare system types: National Health Service, social health insurance system, and private health insurance system. Comparative case-studies on OECD countries indicate a hybridization trend from relatively pure to mixed healthcare systems during the era of 'permanent austerity'. The adequate question is therefore, how and why the role of the state has changed in the relatively mixed Dutch social health insurance system. In order to approach this research question in a systematic way, we distinguish between three dimensions of the healthcare system: regulation, financing, and service provision. In the regulation dimension we observe an increasing state influence on coverage by an incremental socialization of the private sector. This progress culminated in 2006 in the merger of sickness funds and private health insurances into a functional social health insurance under private law. Since the early 1980s the state also directly intervened in the corporatist bargaining of providers and insurers in order to contain costs and regain global competiveness. At the beginning of the new millennium tight budgets resulting in long waiting lists were no longer accepted against the background of a booming economy. Instead, the role of competition increased through new opportunities and incentives for selective contracting between insurers and providers. Therefore, we observe a shift from corporatist self-regulation towards state-regulated market competition within the institutional framework of a social health insurance system. This ongoing reform process towards a welfare market for medical goods was supported by the main political parties on the left and right in order to enhance efficiency and safeguard solidarity.
|Date of creation:||2010|
|Date of revision:|
|Contact details of provider:|| Postal: Parkallee 39, 28209 Bremen|
Web page: http://www.sfb597.uni-bremen.de/
More information through EDIRC
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.:
- Patricia M. Danzon & Jonathan D. Ketcham, 2003.
"Reference Pricing of Pharmaceuticals for Medicare: Evidence from Germany, the Netherlands and New Zealand,"
NBER Working Papers
10007, National Bureau of Economic Research, Inc.
- Danzon Patricia M. & Ketcham Jonathan D., 2004. "Reference Pricing of Pharmaceuticals for Medicare: Evidence from Germany, the Netherlands, and New Zealand," Forum for Health Economics & Policy, De Gruyter, vol. 7(1), pages 1-56, January.
- Patricia M. Danzon & Jonathan D. Ketcham, 2004. "Reference Pricing of Pharmaceuticals for Medicare: Evidence from Germany, the Netherlands, and New Zealand," NBER Chapters, in: Frontiers in Health Policy Research, Volume 7, pages 1-54 National Bureau of Economic Research, Inc.
- Krugman, Paul, 1987. "The narrow moving band, the Dutch disease, and the competitive consequences of Mrs. Thatcher : Notes on trade in the presence of dynamic scale economies," Journal of Development Economics, Elsevier, vol. 27(1-2), pages 41-55, October.
- Brouwer, Werner & van Exel, Job & Hermans, Bert & Stoop, Arjen, 2003. "Should I stay or should I go? Waiting lists and cross-border care in the Netherlands," Health Policy, Elsevier, vol. 63(3), pages 289-298, March.
- Brouwer, Werner B. F. & Hermans, Herbert E. G. M., 1999. "Private clinics for employees as a Dutch solution for waiting lists: economic and legal arguments," Health Policy, Elsevier, vol. 47(1), pages 1-17, April.
When requesting a correction, please mention this item's handle: RePEc:zbw:sfb597:141. See general information about how to correct material in RePEc.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (ZBW - German National Library of Economics)
If references are entirely missing, you can add them using this form.