Dutch Health Insurance Exchanges
| Autor: | Ryan Lynch, Eline Altenburg-van den Broek |
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| Rok vydání: | 2013 |
| Předmět: | |
| Zdroj: | Health Affairs. 32:1687-1687 |
| ISSN: | 1544-5208 0278-2715 |
| Popis: | Dutch Health Insurance Exchanges Ewout van Ginneken and coauthors described the Swiss and Dutch models of managed competition and offered five key lessons for the operations of the US exchanges (Apr 2013). We agree with the authors’ main conclusion that managed competition among health plans by itself will not substantially drive down costs, but we do not agree that “insurers in the Netherlands are clearly engaged in robust competition.” In 2010 we found that the Herfindahl-Hirschman Index (HHI)— used by the US Department of Justice and Federal Trade Commission to calculate market concentration—for the Dutch health care system was 2,111, which placed it in the category of “concentrated” markets. Markets with a score of 1,000–1,800 are considered “moderately concentrated,” and markets with a score of more than 1,800 are considered “concentrated.” Based on the figures available for 2012, the Dutch health care system’s HHI has increased to 2,277, putting it further into the “concentrated” category. In the year prior to the reforms of 2006, the Dutch system was only “moderately concentrated,” with an HHI of 1,346. There are strong arguments for and against consolidation in the US health care market. However, we should at least bear in mind the lessons of the Dutch reform, including the risk that managed competition could lead to a highly concentrated insurancemarket bereft of meaningful choice for consumers. |
| Databáze: | OpenAIRE |
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