Municipal governments' role in averting access problems associated with market reform.
BACKGROUND
The 2006 health insurance legislation obligates each resident to purchase a basic health policy. If a person fails to purchase a basic health plan, (s)he is by implication uninsured. An assumption underpinning the new legislation is that consumers must take responsibility for themselves and can make informed choices. In the view of municipal governments, social security recipients in their community often are not competent enough to do so and for that reason need support. The study investigates how municipal governments provided them with administrative support to prevent them becoming uninsured.


METHODS
Empirical data for this research were collected by desk research.


RESULTS
Municipal governments actively support social security recipients. Individual responsibility and consumer choice are good for the great majority of the population, but may entail problems for social security recipients. To avoid that they are uninsured or become a defaulter, municipal governments conclude a group contract with health insurers. There are clear indications that this strategy has been effective to reduce the number of uninsured people.


CONCLUSIONS
Health insurance legislation based on the principle of individual responsibility requires a policy to support social security recipients in society. Such a policy may imply restrictions to individual responsibility.
Bartholomée
Yvette
Y
Department of Health Organisation, Policy and Economics, Maastricht University, Maastricht, The Netherlands.
Maarse
Hans
H
D000368:Aged; D003159:Community-Institutional Relations; D036262:Empirical Research; D018166:Health Care Reform / Q000331:legislation & jurisprudence*; D019981:Health Care Sector / Q000331:legislation & jurisprudence; D006297:Health Services Accessibility; D006299:Health Services for the Aged / Q000331:legislation & jurisprudence*; D006801:Humans; D019458:Insurance Coverage / Q000331:legislation & jurisprudence*; D007348:Insurance, Health / Q000331:legislation & jurisprudence*; D009111:Local Government; D017057:Medically Uninsured / Q000706:statistics & numerical data; D009426:Netherlands; D024382:Professional Role; D012941:Social Responsibility; D012943:Social Security / Q000191:economics / Q000331:legislation & jurisprudence; D012944:Social Support