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Governing competitive insurance market reform: case studies from the Netherlands and Switzerland

van Ginneken E
erschienen in
Greer S L, Wismar M, Figueras J: Strengthening Health System Governance; ISBN: 978-0-3352-6134-5, pp 129 - 142
Open University Press




Introduction: what is the policy?

Insurance competition is seen as a tool to improve efficiancy in health care. In the European Union, several countries rely on insurance competition. These include Belgium, the Czech Republic, Germany, the Netherlands, Slovakia and Switzerland. All of these countries have systems that allow people to choose periodically among risk-bearing insurance funds (Van de Ven et al. 2013). In theory, health insurance competition can improve efficiency in administration and delivery: (1) if there is free consumer mobility between funds; (2) if insurers do not have incentives to select risks; and (3) if insurers are able to influence (and thus compete on) health service costs and quality (Thomson et al. 2013). The latter implies that insurance competition is not limited to the insurance market, but that also important supporting reforms in the health care pruchasing market are needed that give insurers the tools to influence cost (e.g., selective contracting, negotiation on prices, contracting). 

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