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Stuck in the middle?

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  • Westra, Daan
  • Wilbers, Gloria
  • Angeli, Federica

Abstract

Pro-competitive reforms have been implemented in many Western healthcare systems, of which the Netherlands is a prominent example. While the pro-competitive reforms in the Dutch specialized care sector have drawn considerable academic attention, mental health care is often excluded. However, in line with other segments of specialized care, pro-competitive legislation has formed the core of mental health care reforms, albeit with several notable differences. Ever since mental health services were included in the Health Insurance Act in 2008, the Dutch mental healthcare sector has been in an ongoing state of reform. Numerous major and minor adaptations have continuously altered the services covered by the basic insurance package, the actors responsible for providing and contracting care, and definitions and measurements of quality. Most notably, insurers and municipalities, which are responsible for selectively contracting those providers that offer high value-for-money, seem insensitive to quality aspects. The question whether the Dutch mental health sector has inherited the best or the worst of a competitive and non-competitive system lingers and international policy makers contemplating reforming their mental health sector should take note.

Suggested Citation

  • Westra, Daan & Wilbers, Gloria & Angeli, Federica, 2016. "Stuck in the middle?," Health Policy, Elsevier, vol. 120(4), pages 345-349.
    • Handle: RePEc:eee:hepoli:v:120:y:2016:i:4:p:345-349
    DOI: 10.1016/j.healthpol.2016.02.014
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    References listed on IDEAS

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    1. Gaynor, Martin & Town, Robert J., 2011. "Competition in Health Care Markets," Handbook of Health Economics, in: Mark V. Pauly & Thomas G. Mcguire & Pedro P. Barros (ed.), Handbook of Health Economics, volume 2, chapter 0, pages 499-637, Elsevier.
    2. David M. Cutler, 2002. "Equality, Efficiency, and Market Fundamentals: The Dynamics of International Medical-Care Reform," Journal of Economic Literature, American Economic Association, vol. 40(3), pages 881-906, September.
    3. Cutler, David, 2002. "Equality, Efficiency, and Market Fundamentals: The Dynamics of International Medical Care Reform," Scholarly Articles 2640584, Harvard University Department of Economics.
    4. van de ven, Wynand P. M. M., 1996. "Market-oriented health care reforms: Trends and future options," Social Science & Medicine, Elsevier, vol. 43(5), pages 655-666, September.
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    2. Arnold P M van der Lee & Lieuwe de Haan & Aartjan T F Beekman, 2019. "Rising co-payments coincide with unwanted effects on continuity of healthcare for patients with schizophrenia in the Netherlands," PLOS ONE, Public Library of Science, vol. 14(9), pages 1-13, September.
    3. Lopes, Francisca Vargas & Riumallo Herl, Carlos J. & Mackenbach, Johan P. & Van Ourti, Tom, 2022. "Patient cost-sharing, mental health care and inequalities: A population-based natural experiment at the transition to adulthood," Social Science & Medicine, Elsevier, vol. 296(C).

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