Workable competition in health care: Prospects for the Dutch design

Abstract

Since 1989 a gradual restructuring of the Dutch health care system is taking place to realize a multiple choice social health insurance system with workable competition among insurers and among health care providers. This paper investigates whether the structural change will induce the intended competition. An examination of the characteristics of the market for health insurance, physician services and hospital services in the Netherlands points out that the scope for competition is limited. If competition is to work, rather extensive government regulation to monitor the conduct of both providers and insurers is needed. Without an effective antitrust policy a high degree of concentration and collusion is likely.

Health Care Reform in the Netherlands, Sweden, and the United Kingdom

“…On the other hand, the emergence of private, for-profit hospital chains in some areas may provide the stimulus that is now lacking. 10 Emergence of regulated or managed markets. In none of these countries have policymakers sought to abandon planning and regulation.…”

Health Care Reform in the Netherlands, Sweden, and the United Kingdom

“…On the other hand, the emergence of private, for-profit hospital chains in some areas may provide the stimulus that is now lacking. 10 Emergence of regulated or managed markets. In none of these countries have policymakers sought to abandon planning and regulation.…”

Organizing the Health Insurance Market

“…22 For a description of health insurance in the Netherlands and a discussion of directions of change, see Ministry of Welfare, Health, andCultural Affairs (1989, 1988). My discussion here draws heavily also on Schut (1991), van de Ven ( , 1991, and van de Ven and van Vliet (1990).…”

Understanding competition between healthcare providers: Introducing an intermediary inter-organizational perspective

“…meso level), and health outcomes (i.e. micro levels) should be considered simultaneously when analysing healthcare reforms [49,50]. Scant academic attention has however been paid to the complex interplay between the policy (macro), inter-organizational (meso), and outcome (micro) levels.…”

Health Care Reform in the Netherlands, Sweden, and the United Kingdom

“…On the other hand, the emergence of private, for-profit hospital chains in some areas may provide the stimulus that is now lacking. 10 Emergence of regulated or managed markets. In none of these countries have policymakers sought to abandon planning and regulation.…”

Organizing the Health Insurance Market

“…22 For a description of health insurance in the Netherlands and a discussion of directions of change, see Ministry of Welfare, Health, andCultural Affairs (1989, 1988). My discussion here draws heavily also on Schut (1991), van de Ven ( , 1991, and van de Ven and van Vliet (1990).…”

Understanding competition between healthcare providers: Introducing an intermediary inter-organizational perspective

“…meso level), and health outcomes (i.e. micro levels) should be considered simultaneously when analysing healthcare reforms [49,50]. Scant academic attention has however been paid to the complex interplay between the policy (macro), inter-organizational (meso), and outcome (micro) levels.…”

Health Care Reform in the Netherlands, Sweden, and the United Kingdom

“…On the other hand, the emergence of private, for-profit hospital chains in some areas may provide the stimulus that is now lacking. 10 Emergence of regulated or managed markets. In none of these countries have policymakers sought to abandon planning and regulation.…”

Organizing the Health Insurance Market

“…22 For a description of health insurance in the Netherlands and a discussion of directions of change, see Ministry of Welfare, Health, andCultural Affairs (1989, 1988). My discussion here draws heavily also on Schut (1991), van de Ven ( , 1991, and van de Ven and van Vliet (1990).…”

Understanding competition between healthcare providers: Introducing an intermediary inter-organizational perspective

“…meso level), and health outcomes (i.e. micro levels) should be considered simultaneously when analysing healthcare reforms [49,50]. Scant academic attention has however been paid to the complex interplay between the policy (macro), inter-organizational (meso), and outcome (micro) levels.…”