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KMID : 1138920080070020015
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Health Insurance Forum
2008 Volume.7 No. 2 p.15 ~ p.30
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The Reform of The Health Insurance System in Nether Lands and Its Policy Implications
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Hwang Rah-Il
Kim Jin-Soo
Ko Ming-Jung
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Abstract
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dual-insurance scheme, strong governmental control, lack of incentives, limited choice of insurers. Therefore, the 2006 health care reform has been pursued on the basis of the Dekker Report of 1987 by social consensus. The 2006 reform, featuring of managed competition, has some of key elements as follows. First, the dual system of insurance was replaced by a universal compulsory insurance scheme covering the entire population. Second, it is operated under the private law arrangements with strong public constraints. Third, it enhanced the fierce competition between insurers by ensuring insurer selection of the insured. Fourth, it specified one basic benefit package of equal nominal premiums for insured persons affiliated with the same health care insurer. Fifth, insurers and providers provided the service on the basis of mutual consensus.
Early results have been favorable with 1)the decrease of medical expenses, 2)the enforcement of selection of insurer and provider and responsibility accordingly, and 3)the improvement of the quality of medical service. Despite this successful development, the constant increase of premiums, dissatisfaction of providers, and management fee are challenging problems at the same time.
Although it is still too early for the evaluation of Dutch reform, it is worth looking at the results to consider intra-insurer competition, consumer’s selection insurance product, flat-rate contribution, competition between medical institutions and management of chronic disease in Korea.
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KEYWORD
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managed competition, health insurance, Dutch
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