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KMID : 1124020100260030139
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Korean Social Security Studies
2010 Volume.26 No. 3 p.139 ~ p.163
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Trends of the New Dutch Health Care Reform and its Policy Implications
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Im Mun-Hyuk
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Abstract
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At the beginning of 2006, the Dutch government introduced a fundamental reform of its health insurance system, based on managed competition. The main idea of the reform is to increase efficiency by promoting competition among health insurers as well as health care providers. Since the new Dutch health care reform is debated internationally as the leading model, a case study of Holland reform may contribute to broadening debates on Korean health policy. Against this background, this paper gives an overview of the key features of the reform and analyzes the effects of the reform and describes its implications for cross-country policy learning. This study takes the perspective that competitive reforms in the Netherlands entail restructuring of regulations rather than their elimination, in order to facilitate market competition. In addition, it is important to emphasize that the Dutch health care reform is a work in progress. So far the emphasis has been on the health insurance market. Although the reform of the health insurance market was a major achievement, the complementary reform of the provision market has only just begun and promoting competition among health care providers will depend on the further improvement of the DTC system, the performance indicators and the risk equalization scheme in future. The first lesson for Korea is that there is little empirical evidence advocating a transit from the current single purchaser system towards a competing multiple third-party purchaser system. Secondly, since selective contracting has hardly occurred in Holland to date, it is difficult to argue the necessity of introducing selective contracting. In conclusion, it is too soon to tell whether the reforms will work as expected or intended, and we should avoid rushing to claiming that the Netherlands offers an appropriate answer for Korea.
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KEYWORD
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Dutch health care reform, managed competition, selective contracting
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