Published 7 September 2009, doi:10.1136/bmj.b3397
Cite this as: BMJ 2009;339:b3397

Analysis

Looking to Europe

The Netherlands: regulated competition behind the dykes?

Gert P Westert, professor of health services research 1,3, Jako S Burgers, senior researcher2, Harry Verkleij, senior researcher3

1 Tilburg University, PO Box 90153, 5000 LE Tilburg, Netherlands, 2 Scientific Institute for Quality of Healthcare, Radboud University Nijmegen Medical Centre, Netherlands, 3 National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720 BA Bilthoven, Netherlands

Correspondence to: G P Westert gert.westert@rivm.nl

doi:10.1136/bmj.a1997, doi:10.1136/bmj.39451.406123.AD, doi:10.1136/bmj.b1170

The first 150 words of the full text of this article appear below.

In 2006 the Netherlands introduced a set of healthcare reforms aimed at improving the efficiency of the country’s health system and getting better value for money. Dutch society, in common with that of many other European countries, is ageing and healthcare costs are expected to peak in 2040. The Dutch ministry of health thought that change was essential if the system was to contain costs and continue to provide equitable access to good quality care. The reforms have attracted much interest, not least in the US, because the Dutch are trying to make private insurance work for public benefit. We describe the reforms, explain why they were introduced, and discuss early evidence of their effect.

The seeds for the 2006 reforms were sown in the late 1980s. In 1987 a committee, headed by the chief executive of Philips, Wisse Dekker, reported that the system lacked efficiency.1 The Dekker report pointed . . . [Full text of this article]


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