ArticlePDF Available

No Pay - No Cure! The Evolution of Cost Containment Policies in Dutch Healthcare

Authors:
Jan-Kees Helderman at Radboud University
Jan-Kees Helderman
Patrick Paulus Theodoor Jeurissen at Radboud University Medical Centre (Radboudumc)
Patrick Paulus Theodoor Jeurissen
Download full-text PDF
Read full-text
Download citation
Content uploaded by Patrick Paulus Theodoor Jeurissen
Author content
All content in this area was uploaded by Patrick Paulus Theodoor Jeurissen on Sep 02, 2014
Content may be subject to copyright.
A preview of the PDF is not available
... However, the continued increase in healthcare expenditure under the new system as a result of larger service volumes was less in the spotlight. It was in part consciously accepted by politicians or addressed with a dilution of the compulsory range of services and the introduction and gradual increase of deductibles (EUR 150 in 2008 to just under EUR 400 in 2016) [52,53]. The health insurance funds -strengthened in this new competitive system -had, however, little incentive to contain costs by means of selective contracting with service providers. ...
Budgetary targets as cost-containment measure in the Swiss healthcare system? Lessons from abroad
Article
Full-text available
  • May 2020
  • HEALTH POLICY
Growing healthcare expenditure is a major concern for policy makers and calls for effective cost containment measures. For the decentralized Swiss healthcare system, ranking second among OECD countries in healthcare spending, a group of experts has proposed budgetary targets as key measure. In order to substantiate this proposal, we review the literature and analyse experiences with budgetary targets in comparable social health insurance systems, such as Germany and the Netherlands. Budgetary targets raise the cost responsibility and prompt providers to give greater weight to cost-benefit considerations. Our analysis suggests that the involvement of all principal healthcare players and clear decision-making and negotiating structures are key to successful implementation. Risks of rationing, lower quality incentives or conservation of structures have to be countered with taking into account age-related morbidity and medical progress when setting the budgetary targets. Accompanying measures such as incentive-compatible remuneration schemes and quality monitoring are of paramount importance.
View
Improving Federal Governance
Article
  • Nov 1980
In 1968, the late Kermit Gordon, then president of The Brookings Institution, asked me to contribute an extended essay on "Managing the Federal Government" to a volume to be entitled Agenda for the Nation (Washington, D.C., The Brookings Institution, 1968). The volume was a series of papers on domestic and foreign-policy issues prepared for the benefit of whoever would take over as President of the United States in January 1969. What follows is an attempt to update what I then wrote and to defend even more forcefully than I did then the concept that the central problems of governance in the United States are not managerial in a narrow structural sense, but political in a dynamic, consensual sense. I am grateful to The Brookings Institution for their willingness to allow me to use parts of my 1968 paper for this 1980 PAR essay.
View
The enactment of national health insurance: A Boolean analysis of twenty advanced industrial countries
Article
  • Sep 2001
The scholarly literature on health care politics has generated a series of hypotheses to explain U.S. exceptionalism in health policy and to explain the adoption of national health insurance (NHI) more generally. Various cultural, institutional, and political conditions are held to make the establishment of some form of national health insurance policy more (or less) likely to occur. The literature is dominated by national and comparative case studies that illustrate the theoretical logic of these hypotheses but do not provide a framework for examining the hypotheses cross-nationally. This article is an initial attempt to address that void by using Boolean analysis to examine systematically several of the major propositions that emerge from the case study literature on the larger universe of twenty advanced industrial democracies. This comparative analysis offers considerable support for the veto points hypothesis while still finding each of the factors examined to be relevant in certain scenarios. We conclude with a discussion of the implications of these findings for future research and for advocates of national health insurance in the United States.
View