The metamorphosis of health planning in the Netherlands and the USA

Abstract

The United States and the Netherlands are the focus for this comparative analysis of the evolutionary interaction between health planning and the political system, seen in the context of change in social and economic ideologies. While health planning in the USA started in 1946, it was the comprehensive health planning program in 1966 that created the form to be followed by Health Systems Agency effort in 1974: local, voluntary planning, coordinated by state agencies, supported by federal funding. Health planning in the Netherlands has moved through four distinct periods: a hospital construction period starting during the post-war recovery; a hospital regionalization period, from 1971 through the late 1970s; a transition period from the late 1970s to 1982, during which several planning approaches were considered; and, the current comprehensive health and social services planning period. Today, federal support for health planning in the US has been eliminated as part of the current de-regulatory, competitive health care strategy. Health planning in the US is now an institutional activity, with less focus on community needs. Advocated changes in the Dutch planning approach incorporate ideas similar to past approaches in the US; but, a failed approach in one nation may work in another, if the underlying cultural and organizational characteristics are sufficiently different.

Epistemic layers in development planning: A case study of the health sector in the Gunungkidul District, Indonesia

“…There are studies which show how social life and political system can penetrate the ways in which health planning works. Kirkman‐Liff et al describe the metamorphosis of health planning in the Netherlands and the United States, stating that an approach in planning that might not work in a country could work in another provided that the underlying cultural and organisational characteristics are sufficiently different. A heuristic understanding of planning would probe how different planning discourses are being mobilised, for strategic effect, by a variety of other players in different stages: front‐stage and back‐stage settings .…”

Hospital role delineation: The technology and the politics

“…Hospital planning has developed differently in market and regulated systems (Kirkman-Liff et al, 1988). This is most clearly demonstrated in the language: in the United States, hospital planning is now called hospital (or even, health care) marketing.…”

Health Insurance Values and Implementation in the Netherlands and the Federal Republic of Germany

“…Such a lack of congruence was one contributor to the failure of health planning, in the form of certificate-of-need legislation and health systems agencies, to obtain last¬ ing political support. 23 Following the discussion of values, the structure of the health care systems in the Netherlands and Germany will be reviewed; the in¬ terested reader can consult any number of more detailed descriptions.24"32 Last, the article will draw from the experi¬ ences of the Netherlands and Germany to develop different recommendations for health reform in this nation.…”