Work engagement refers to an active energetic state of mind that is characterized by vigor, dedication, and absorption. Despite practitioner's attention for work engagement, few public administration scholars have studied public servants' work engagement empirically. The goal of this study is to extend the job demands-resources (JD-R) model of work engagement using insights from the public administration literature. The analysis of a large-scale survey (N = 9,465) shows that (a) work and personal resources, including public service motivation, are positively related to work engagement; (b) red tape moderates these relationships; and (c) work engagement mediates the relationship between JD-R and job outcomes. In conclusion, public organizations can potentially increase work engagement and inherently employee outcomes by increasing work-related resources (autonomy, cooperation with colleagues) and selecting personnel with a proactive personality and high levels of public service motivation.

Eager to learn from private sector trends, practitioners in (semi)public organizations across the world have recently turned their eyes to the concept of work engagement to improve employee performance. Studies in the private sector show that work engagement is a more robust predictor of performance than, for example, satisfaction. The goal of this study is to find out whether the effects of work engagement on attitudinal, behavioral, and performance outcomes within the semipublic and public sector are also as high as expected and whether these relationships differ between the public, semipublic, and private sector. The results of the cross-sectoral meta-analysis of 130 studies showed that the most noticeable significant sectoral differences can be found in the mean work engagement and the effects of work engagement on the level of attitudinal outcomes (job satisfaction and commitment) and behavioral outcomes (workaholism and turnover intention).

In the Netherlands, current policy opinion emphasizes demand-driven health care. Central to this model is the view, advocated by some Dutch health policy makers, that patients should be encouraged to be aware of and make use of health quality and health outcomes information in making personal health care provider choices. The success of the new health care system in the Netherlands is premised on this being the case. After a literature review and description of the new Dutch health care system, the adequacy of this demand-driven health policy is tested. The data from a July 2005, self-administered questionnaire survey of 409 patients (response rate of 94%) as to how they choose a hospital are presented. Results indicate that most patients did not choose by actively employing available quality and outcome information. They were, rather, referred by their general practitioner. Hospital choice is highly related to the importance a patient attaches to his or her physician's opinion about a hospital. Some patients indicated that their hospital choice was affected by the reputation of the hospital, by the distance they lived from the hospital, etc. but physician's advice was, by far, the most important factor. Policy consequences are important; the assumptions underlying the demanddriven model of patient health provider choice are inadequate to explain the pattern of observed responses. An alternative, more adequate model is required, one that takes into account the patient's confidence in physician referral and advice.

The 2006 Enthoven-inspired Dutch health insurance reform, based on regulated competition with a mandate for individuals to purchase insurance, will interest U.S. policy makers who seek universal coverage. This ongoing experiment includes guaranteed issue, price competition for a standardized basic benefits package, community rating, sliding-scale income-based subsidies for patients, and risk equalization for insurers. Our assessment of the first two years is based on Dutch Central Bank statistics, national opinion polls, consumer surveys, and qualitative interviews with policy makers. The first lesson for the United States is that the new Dutch health insurance model may not control costs. To date, consumer premiums are increasing, and insurance companies report large losses on the basic policies. Second, regulated competition is unlikely to make voters/citizens happy; public satisfaction is not high, and perceived quality is down. Third, consumers may not behave as economic models predict, remaining responsive to price incentives. Finally, policy makers should not underestimate the opposition from health care providers who define their profession as more than simply a job. If regulated competition with individual mandates performs poorly in auspicious circumstances such as the Netherlands, how will this model fare in the United States, where access, quality, and cost challenges are even greater? Might the assumptions of economic theory not apply in the health sector?

The study is designed to provide an informal summary of what is known about consumer switching of health insurance plans and to contribute to knowledge about what motivates consumers who choose to switch health plans. Do consumers switch plans largely on the basis of critical reflection and assessment of information about the quality, and price? The literature suggests that switching is complicated, not always possible, and often overwhelming to consumers. Price does not always determine choice. Quality is very hard for consumers to understand. Results from a random sample survey (n = 2791) of the Alkmaar region of the Netherlands are reported here. They suggest that rather than embracing the opportunity to be active critical consumers, individuals are more likely to avoid this role by handing this activity off to a group purchasing organization. There is little evidence that consumers switch plans on the basis of critical reflection and assessment of information about quality and price. The new data reported here confirm the importance of a group purchasing organizations. In a free-market-health insurance system confidence in purchasing groups may be more important for health insurance choice than health informatics. This is not what policy makers expected and might result a less efficient health insurance market system.

the patients and medical specialists researched did not show wide differences of opinion on preferences of care in relation to quality. The only exception to this concerned 'continuity of care' which was ranked higher by patients.

A proud public servant is defined as someone who works honorably, conscientiously, and with dedication. Although professional pride has several positive effects on the performances of public servants, it is not instantly apparent which instruments help to stimulate pride. This study combines the Job Demands-Resources model and the High Performance Work Practices taxonomy to analyze the determinants of pride. The analysis of a large dataset of Dutch public servants shows that their professional pride can barely be influenced by High-Performance Work Practices but is in particular determined by the work environment and personal experiences related to the work.

Introduction: Since the introduction of the Health Insurance Act in the Netherlands in 2006, insurers are incentivized to compete on prices for basic health insurance, and on price and quality for supplementary insurance. The new health insurance system aimed to create a more competitive market in which consumers would switch health plans, thereby stimulating insurers to price competition and quality improvement. This article evaluates the switching behavior of Dutch consumers and evaluates whether this behavior is advantageous to the goals of the reform. Methods: Three surveys were conducted: from 2005-2006 (n = 478), 2008-2009 (n = 389), and 2010-2011 (n = 191). Results: In 2005-2006, almost 20 percent of the Dutch consumers switched their insurance company. In between 2006 and 2012, however, the percentage of switchers decreased to less than four percent. The main cause of this decrease is that consumers no longer perceive sufficient differences between insurance companies in terms of premium and service. In addition, consumers have difficulties finding the proper information making the right decision and believe they may not be accepted for the supplementary insurance. Consequently, insurance companies only perceive limited incentives to create a more competitive market. Conclusion: Clear and unambiguous information, combined with an obligatory acceptance for the supplementary insurance might help to improve the potential mobility of Dutch consumers