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The impact of reforms of national health insurance on solidarity in the Netherlands: comparing health care insurance and long-term care insurance

Author

Listed:
  • Van der Aa, Maartje J.
  • Paulus, Aggie T.G.
  • Klosse, Saskia
  • Evers, Silvia M.A.A.
  • Maarse, Johannes A. M.

Abstract

Context: Throughout Europe, the financial risks of health and long-term care are covered to varying degrees through models of national (health) insurance. Such insurance draws upon the principle of solidarity. Much is unknown on the solidarity-effects of reforms in national insurance schemes. Objective: To present an empirical analysis of the effects of recent reforms in national health insurance on solidarity in one country. Methods: We conducted a comparative analysis of the 2006 health care insurance reform and the 2015 long-term care insurance reform in the Netherlands. A multidimensional analytical framework of solidarity was developed to study the solidarity-effects of both reforms. Findings: Reforms of health care and long-term care insurance in the Netherlands had some solidarity effects, but they should not be overstated. We found evidence for increased and decreased solidarity. Health care insurance seems more ‘immune’ to reductions in solidarity than long-term care insurance. Limitations: The present case study involves reforms in the Netherlands. The solidarity framework is specifically designed for the study of solidarity-effects of reforms on national health and long-term care insurance. Effects on informal arrangements for care are beyond the scope of this study. More detailed and quantitative research is required to investigate how the reforms played out for specific groups, for instance the frail elderly, people with a disability and people with rare conditions. Similarly, long-term effects require further investigation. Implications: Given the limited scope of our analysis, more comparative research (including on an international scale) is required to develop systematic insight into the solidarity-effects of reforms in national health and long-term care insurance.

Suggested Citation

  • Van der Aa, Maartje J. & Paulus, Aggie T.G. & Klosse, Saskia & Evers, Silvia M.A.A. & Maarse, Johannes A. M., 2019. "The impact of reforms of national health insurance on solidarity in the Netherlands: comparing health care insurance and long-term care insurance," LSE Research Online Documents on Economics 106225, London School of Economics and Political Science, LSE Library.
    • Handle: RePEc:ehl:lserod:106225
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    References listed on IDEAS

    as
    1. Erik Schut & Stéphane Sorbe & Jens Høj, 2013. "Health Care Reform and Long-Term Care in the Netherlands," OECD Economics Department Working Papers 1010, OECD Publishing.
    2. Esther Mot, 2010. "The Dutch system of long-term care," CPB Document 204.rdf, CPB Netherlands Bureau for Economic Policy Analysis.
    3. Thomson, Sarah & Busse, Reinhard & Crivelli, Luca & van de Ven, Wynand & Van de Voorde, Carine, 2013. "Statutory health insurance competition in Europe: A four-country comparison," Health Policy, Elsevier, vol. 109(3), pages 209-225.
    4. Maarse, J.A.M. (Hans) & Jeurissen, P.P. (Patrick), 2016. "The policy and politics of the 2015 long-term care reform in the Netherlands," Health Policy, Elsevier, vol. 120(3), pages 241-245.
    5. 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.
    6. van Esch, Thamar E.M. & Brabers, Anne E.M. & van Dijk, Christel E. & Gusdorf, Lisette & Groenewegen, Peter P. & de Jong, Judith D., 2017. "Increased cost sharing and changes in noncompliance with specialty referrals in The Netherlands," Health Policy, Elsevier, vol. 121(2), pages 180-188.
    7. Turo-Kimmo Lehtonen & Jyri Liukko, 2011. "The Forms and Limits of Insurance Solidarity," Journal of Business Ethics, Springer, vol. 103(1), pages 33-44, April.
    8. P. P. T. Jeurissen & F. B. M. Sanders, 2007. "Solidarity: who cares?," Springer Books, in: Onno Steenbeek & Fieke Lecq (ed.), Costs and Benefits of Collective Pension Systems, chapter 3, pages 33-48, Springer.
    9. Esther Mot, 2010. "The Dutch system of long-term care," CPB Document 204, CPB Netherlands Bureau for Economic Policy Analysis.
    10. Stadhouders, Niek & Koolman, Xander & Tanke, Marit & Maarse, Hans & Jeurissen, Patrick, 2016. "Policy options to contain healthcare costs: a review and classification," Health Policy, Elsevier, vol. 120(5), pages 486-494.
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    Cited by:

    1. Meijer, Marloes A. & Brabers, Anne E.M. & de Jong, Judith D., 2023. "Has public support for solidarity in healthcare financing in the Netherlands changed over time? A repeated cross-sectional study," Health Policy, Elsevier, vol. 131(C).

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    More about this item

    Keywords

    solidarity; health care insurance; long-term insurance; Netherlands;
    All these keywords.

    JEL classification:

    • E6 - Macroeconomics and Monetary Economics - - Macroeconomic Policy, Macroeconomic Aspects of Public Finance, and General Outlook

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