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Effects of purchaser competition in the Dutch health system: is the glass half full or half empty?

Published online by Cambridge University Press:  26 January 2011

Frederik T. Schut  and
Wynand P. M. M. van de Ven
Frederik T. Schut*
Affiliation:
Professor of Health Economics, Institute for Health Policy and Management, Erasmus University Rotterdam, The Netherlands
Wynand P. M. M. van de Ven
Affiliation:
Professor of Health Insurance, Institute for Health Policy and Management, Erasmus University Rotterdam, The Netherlands
*
Correspondence to: Frederik T. Schut, Professor of Health Economics, Institute for Health Policy and Management, Erasmus University Rotterdam, PO Box 1738, 3000 DR Rotterdam, The Netherlands. Email: schut@bmg.eur.nl
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Abstract

In 2006, the Dutch health insurance system was radically reformed to strengthen competition among health insurers as purchasers of health services. This article considers whether purchaser competition has improved efficiency in health-care provision. Although supply and price regulation still dominates the allocation of health services, purchaser competition has already significantly affected the provision of hospital care, pharmaceuticals and primary care, as well as efforts to gather and disseminate information about quality of care. From this perspective, the glass is half full. However, based on the crude performance indicators available, the reforms have not yet demonstrated significant effects on the performance of the Dutch health system. From this perspective the glass is half empty. The article concludes that the effectiveness of purchaser competition depends crucially on the success of ongoing efforts to improve performance indicators, product classification and the risk equalisation scheme.

Type
Debate
Information
Health Economics, Policy and Law , Volume 6 , Issue 1 , 26 January 2011 , pp. 109 - 123
Copyright
Copyright © Cambridge University Press 2011

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