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首页> 外文期刊>Journal of health politics, policy and law >An experiment with regulated competition and individual mandates for universal health care: the new dutch health insurance system.
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An experiment with regulated competition and individual mandates for universal health care: the new dutch health insurance system.

机译：一项具有规范竞争和针对全民医疗保健的个人授权的实验：新的荷兰医疗保险体系。

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The 2006 Enthoven-inspired Dutch health insurance reform, based on regulated competition with a mandate for individuals to purchase insurance, will interest U.S. policy makers who seek universal coverage. This ongoing experiment includes guaranteed issue, price competition for a standardized basic benefits package, community rating, sliding-scale income-based subsidies for patients, and risk equalization for insurers. Our assessment of the first two years is based on Dutch Central Bank statistics, national opinion polls, consumer surveys, and qualitative interviews with policy makers. The first lesson for the United States is that the new Dutch health insurance model may not control costs. To date, consumer premiums are increasing, and insurance companies report large losses on the basic policies. Second, regulated competition is unlikely to make voters/citizens happy; public satisfaction is not high, and perceived quality is down. Third, consumers may not behave as economic models predict, remaining responsive to price incentives. Finally, policy makers should not underestimate the opposition from health care providers who define their profession as more than simply a job. If regulated competition with individual mandates performs poorly in auspicious circumstances such as the Netherlands, how will this model fare in the United States, where access, quality, and cost challenges are even greater? Might the assumptions of economic theory not apply in the health sector?
机译：2006年受荷兰人（Enthoven）启发的荷兰医疗保险改革，是基于受监管的竞争，要求个人购买保险，这将吸引寻求全民保险的美国决策者。这项正在进行的实验包括：担保问题，针对标准化基本福利计划的价格竞争，社区评级，对患者的按比例缩放的基于收入的补贴以及对保险公司的风险均等化。我们对前两年的评估基于荷兰中央银行的统计数据，国家民意测验，消费者调查以及对政策制定者的定性采访。美国的第一课是，新的荷兰健康保险模式可能无法控制成本。迄今为止，消费者保费在增加，而保险公司报告其基本保单损失惨重。第二，规范的竞争不太可能使选民/公民高兴。公众满意度不高，感知质量下降。第三，消费者可能不会像经济模型所预测的那样表现出来，仍然对价格激励做出反应。最后，政策制定者不应低估来自医疗保健提供者的反对，他们将自己的职业定义为不仅仅是工作。如果在荷兰这样的吉祥环境下，具有个别任务的受规制竞争的表现不佳，那么这种模式在美国将如何发挥作用，因为美国在获取，质量和成本方面的挑战更大？经济理论的假设可能不适用于卫生部门吗？

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