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Choice of providers and mutual healthcare purchasers: can the English National Health Service learn from the Dutch reforms?

Bevan, Gwyn and 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? Health Economics, Policy and Law, 5 (03). pp. 343-363. ISSN 1744-1331

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Abstract

In the 1990s, countries experimented with two models of health care reforms based on choice of provider and insurer. The governments of the UK, Italy, Sweden and New Zealand introduced relatively quickly ‘internal market’ models into their single-payer systems, to transform hierarchies into markets by separating ‘purchasers’ from ‘providers’, and enabling ‘purchasers’ to contract selectively with competing public and private providers so that ‘money followed the patient’. This model has largely been abandoned where it has been tried. England, however, has implemented a modified ‘internal market’ model emphasising patient choice, which has so far had disappointing results. In the Netherlands, it took nearly 20 years to implement successfully the model in which enrollees choose among multiple insurers; but these insurers have so far only realised in part their potential to contract selectively with competing providers. The paper discusses the difficulties of implementing these different models and what England and the Netherlands can learn from each other. This includes exploration, as a thought experiment, of how choice of purchaser might be introduced into the English National Health Service based on lessons from the Netherlands.

Item Type: Article
Official URL: http://journals.cambridge.org/action/displayJourna...
Additional Information: © 2010 Cambridge University Press
Library of Congress subject classification: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Journal of Economic Literature Classification System: I - Health, Education, and Welfare > I1 - Health > I18 - Government Policy; Regulation; Public Health
O - Economic Development, Technological Change, and Growth > O5 - Economywide Country Studies > O57 - Comparative Studies of Countries
Sets: Departments > Management
Research centres and groups > Centre for Analysis of Risk and Regulation (CARR)
Research centres and groups > LSE Health
Rights: http://www.lse.ac.uk/library/usingTheLibrary/academicSupport/OA/depositYourResearch.aspx
Date Deposited: 04 Jan 2011 12:29
URL: http://eprints.lse.ac.uk/31085/

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