Results of the market-oriented reform in the Netherlands: a review.
The market-oriented reform in the Dutch health care system is now in its 10th year. This article offers a concise overview of some of its effects thus far on health insurance, healthcare purchasing and healthcare provision. Furthermore, attention is given to its impact on healthcare expenditures, power and trust relationships as well as the relationship between the Minister of Health and the Dutch Healthcare Authority. The reform triggered various alterations in Dutch health care some occurring quickly (e.g. health insurance), others taking longer (e.g. purchasing). These developments suggest a process of gradual transformation. The reform has instigated controversy which is increasingly framed as a power conflict between insurers and providers. Weakened consumer trust in insurers threatens the legitimacy of the reform. The relationship between Minister and Healthcare Authority appears to be more intimate than the formal independent status of this regulatory agency would suggest.
1Department of Health Services Research,Maastricht University,Maastricht,the Netherlands.
Hans
H
Maarse
2Celsus Academy,Radboud University,Nijmegen and Ministry of Health,Welfare and Sports,The Hague,the Netherlands.
Patrick
P
Jeurissen
1Department of Health Services Research,Maastricht University,Maastricht,the Netherlands.
Dirk
D
Ruwaard
D002755:Choice Behavior; D004465:Economic Competition; D018166:Health Care Reform; D007343:Insurance Carriers / Q000191:economics; D007348:Insurance, Health / Q000191:economics / Q000331:legislation & jurisprudence; D009426:Netherlands