Recently, we published the 2010 Health Systems in Transition review for the Netherlands.1 It is the first attempt to give a full blown description of the Dutch health system after major health reform in 2006. This reform, introduced after almost two decades of preparation, has brought important new regulatory mechanisms and structures to the Dutch health system. The reform can be seen as the re...

According to the recent literature, we are experiencing a managed care "revolution," and managed competition is increasingly being embraced by private- and public-sector policymakers. Using two large employer health insurance surveys, this paper presents new estimates that both confirm and add to our understanding of changes taking place in employment-based health plans. The dramatic shifts in ...

As phrases like "managed care backlash" become part of the lexicon in American health care policy circles, it is instructive to examine a managed competition experiment in a vastly different context. Britain's Conservative government instituted reforms in 1991 to transform the National Health Service (NHS) from a centrally administered service to managed competition between purchasers and provi...

BACKGROUND A persistent feature of international health policy debate is whether a single-payer or multiple-payer system can offer superior performance. In Ireland, a major reform proposal is the introduction of 'managed competition' based on the recent reforms in the Netherlands, which would replace many functions of Ireland's public payer with a system of competing health insurers from 2016. ...

VIEWPOINT Reform of health-care systems in the past decade has been driven by ideas such as public/private partnerships, managed competition, managed care, and integrated care. These abstractions betray the grand nature of ambitions harboured by reformers. Faced with funding pressures on the one hand, and failures of service delivery on the other, policymakers have entertained radical solutions...

The essays in this volume concentrate heavily on "managed competition," which is merely a particular form of controlling the flow of funds from an insurance pool to the providers of health care. By contrast, this essay emphasizes the funneling of money into the insurance fund. It is argued inter alia that American business has been a quite unreliable partner in the financing of American health ...

Minneapolis/St. Paul, because of its history of health maintenance organization development and active employer participation in the health care arena, is often cited as a community in which managed competition has been tested to some degree. This paper reviews the historical development of the Twin Cities health care market and summarizes findings from past studies of this market. It also desc...

Data from the 1997 Robert Wood Johnson Foundation Employer Health Insurance Survey provide new information comparing public- and private-sector employee health benefits. The federal government is ahead of other employers in adopting managed competition principles using financial incentives and consumer information to promote choosing efficient plans. Federal employees experience a $200 annual c...

In a health care system based on managed competition, health insurers negotiate on quality and price with care providers and are allowed to offer restrictive health plans. It is crucial that enrolees who need care choose restrictive health plans, as otherwise health insurers cannot channel patients to contracted providers and they will lose their bargaining power in negotiations with providers....

One essential component of health system reform is to bring the number of physicians in line with the needs of the population. The physician supply policies of prepaid group practice health maintenance organizations have been cited as one model to achieve this goal. Planning for physician supply should be an explicit public-sector activity and should not be left to the private sector, because s...