Changes and Challenges of the New Health Care Reform in the Netherlands: What Should the Dutch Be Aware of?

In this paper we examine the recent change of health care policy reform in the Netherlands, which introduced elements of market competition into the system with the goals of strengthening solidarity, guaranteeing an equitable and cost-efficient health care market, and preserving individuals' freedom of choice concerning health care providers. We draw a parallel with the Swiss health care system, which relies on ten years of experience with managed competition in health care, and highlight the difficulties emerging from a set-up that does not always guarantee a competitive environment. The lesson that the Dutch should learn is that competition can only work if there is a substantial liberalization on the procurement market (more room for selectively contracting providers of care) and if sufficient incentives to stimulate an increased role of the consumer are present.