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Managed competition in the Dutch Health Care System: Preconditions and experiences so far

Author

Listed:
  • Richard C. van Kleef

    (Erasmus University Rotterdam)

Abstract
In the early 1990's the Dutch government started to replace supply-side regulation in health care by managed competition. The idea of managed competition is that insurers and providers of care compete on price and quality while the government establishes certain rules to guarantee public objectives. The ultimate goal of the reforms is to achieve a health care system in which incentives for efficiency are combined with universal access to good-quality care. For successful application of managed competition, however, some important preconditions need to be fulfilled. This paper describes these preconditions and discusses how and to what extent they are fulfilled in the Netherlands. Special attention will be paid to the corner stone of managed competition: risk equalization. An important lesson from the Netherlands is that fulfilling these preconditions is a long process. The experiences so far reveal some positive effects as well as some serious issues that need to be solved.

Suggested Citation

  • Richard C. van Kleef, 2012. "Managed competition in the Dutch Health Care System: Preconditions and experiences so far," Public Policy Review, Policy Research Institute, Ministry of Finance Japan, vol. 8(2), pages 145-170, July.
    • Handle: RePEc:mof:journl:ppr016c
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    File URL: http://warp.ndl.go.jp/info:ndljp/pid/10248500/www.mof.go.jp/english/pri/publication/pp_review/ppr016/ppr016c.pdf
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    References listed on IDEAS

    as
    1. R. Kleef & K. Beck & W. Ven & R. Vliet, 2007. "Does risk equalization reduce the viability of voluntary deductibles?," International Journal of Health Economics and Management, Springer, vol. 7(1), pages 43-58, March.
    2. van Kleef, R.C. & Beck, K. & van de Ven, W.P.M.M. & van Vliet, R.C.J.A., 2008. "Risk equalization and voluntary deductibles: A complex interaction," Journal of Health Economics, Elsevier, vol. 27(2), pages 427-443, March.
    3. Office of Health Economics, 2007. "The Economics of Health Care," For School 001490, Office of Health Economics.
    4. Lamers, Leida M., 1998. "Risk-adjusted capitation payments: Developing a diagnostic cost groups classification for the Dutch situation," Health Policy, Elsevier, vol. 45(1), pages 15-32, July.
    5. Bevan, Gwyn & van de Ven, Wynand P. M. M., 2010. "Choice of providers and mutual healthcare purchasers: can the English National Health Service learn from the Dutch reforms?1," Health Economics, Policy and Law, Cambridge University Press, vol. 5(3), pages 343-363, July.
    6. Cutler, David, 2002. "Equality, Efficiency, and Market Fundamentals: The Dynamics of International Medical Care Reform," Scholarly Articles 2640584, Harvard University Department of Economics.
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    Cited by:

    1. Willemse-Duijmelinck, Daniëlle M.I.D. & van de Ven, Wynand P.M.M. & Mosca, Ilaria, 2017. "Supplementary insurance as a switching cost for basic health insurance: Empirical results from the Netherlands," Health Policy, Elsevier, vol. 121(10), pages 1085-1092.

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