In a previous post one of us (Gaynor) examined some evidence
on whether price controls are effective in slowing the rate of growth of health
care spending, and how they compare with competition in private markets. In
this post we examine some evidence from the Netherlands that may bear on the
matter. In the previous post a data point from the Netherlands was shown as
part of an international comparison, but it’s worthwhile to examine the Netherlands experience a bit
further. The Netherlands is particularly interesting because they have employed
rate setting in health care and subsequently deregulated much of their health
sector to allow prices to be market determined. The question of whether the end
of rate setting and the introduction of competition raised or lowered health
care costs and prices in the Netherlands is hotly debated.
The article
by Steven Brill in Time also led also to a lot of discussion in the
Netherlands. Rob Wijnberg (former editor of the important Dutch Newspaper
NRC-next) tweeted, “brilliant article about the reasons why competition in
health care doesn’t work" (https://twitter.com/robwijnberg,
Feb 26, translation M. Mikkers).
Health reform in the Netherlands has been gradual and has
had a number of different elements. Initially competition in health insurance
was introduced (with an individual mandate), while maintaining rate setting for
providers. A partial and gradual deregulation of provider prices followed. For
hospitals some services have been deregulated (this is called the B Segment)
and some services remain under price controls (the A Segment). The proportion
of services in the deregulated B Segment has increased over time. In 2005 8% of
hospital services were in the B-segment. This percentage then increased to 20%
and 30% in 2008 and 2009 respectively. In 2012 virtually all elective care (70%
of hospital services) was in the B segment.
The figure below
(source: Market Scan Hospital Market 2011, Netherlands Healthcare Authority [in Dutch]) shows the percentage change in hospital prices over time in the price
controlled A Segment and deregulated B Segment. As can be seen, growth in the
deregulated segment, where prices are market determined, is substantially lower
from about 2006-2007 onwards. In fact, from about 2008-2009 to 2010-2011 prices
were falling in the deregulated segment while they were still growing in the
price controlled segment. This doesn’t necessarily mean that competition
controls prices and rate setting does not (lots of other things could be going
on), but neither do we see what we’d expect if rate setting was doing a
superior job of controlling prices.

In sum, the Netherlands is a good place to look for the
effects of rate setting versus markets on prices and spending, since they have
employed both. A quick look at some descriptive statistics doesn’t yield any
slam dunks for rate setting. If anything, shifting to markets may have substantially
reduced price growth. However, careful study will be required in order to draw
firmer conclusions. Last, while we believe that there are lessons for the US
from experiences in other countries (and vice versa), we do have to be cautious
in making strong inferences across very different health care systems and
societies.
Great article. I've read that the Life Sciences and Health sector is becoming more and more important. In fact, these are one of the prosperous sectors! SIRE Life Sciences has written an article on this, see here - http://sirelifesciences.maussen.com/104511-topsector-life-sciences-health-is-onmisbaar-voor-een-gezond-en-welvarend-nederland. They provide a lot of interesting articles about the Life Sciences industry, you can find them on the website - http://sirelifesciences.maussen.com/.
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Thanks,
Pastor God'stime Alisha
Good Day Sir/Madam: Do you need an urgent loan to finance your business or in any purpose? We are certified and legitimate and international licensed loan lender we offer loans to Business firms. Individuals, companies firms, corporate bodies at an affordable interest rate of 3%. It might be a short or long term loan or even if you have poor credit. We shall process your loan as soon as we receive your application. We are an independent financial institution. We have built up an excellent reputation over the years in providing various types of loans to thousands of our customers. We offer Educational loan, Business loan, home loan, Agricultural loan, Personal loan, Auto loan with either a good or bad credit history. If you are interested in our above loan offer you are advice to fill the below information and return to us for more details. You can contact us with this email (standardonlineinvestment@gmail.com) we shall respond to you as soon as we receive your loan application details below.
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( standardonlineinvestment@gmail.com )for immediate attention. Contact
us now and get an urgent loan within two (2) days!!!
Regards,
Mr Abdul Muqse
My Brothers and Sister all over the world, I am Mrs Boo Wheat from Canada ; i was in need of loan some month ago. i needed a loan to open my restaurant and bar, when one of my long time business partner introduce me to this good and trustful loan lender DR PURVA PIUS that help me out with a loan, and is interest rate is very low , thank God today. I am now a successful business woman, and I became useful. In the life of others, I now hold a restaurant and bar. And about 30 workers, thank GOD for my life I am leaving well today a happy father with three kids, thanks to you DR PURVA PIUS Now I can take care of my lovely family, i can now pay my bill. I am now the bread winner of my family. If you are look for a trustful and reliable loan leader. You can Email him via,mail (urgentloan22@gmail.com) Please tell him Mrs Boo Wheat from Canada introduce you to him. THANKS
ReplyDeleteWe Offer Private, Commercial and Personal Loans with very Minimal annual Interest Rates as Low as 3% . We give out loans within the range of $1,000 to $100,000,000.If you are interested reply me now.Contact us via Email: capitalfundings3@gmail.com
ReplyDeleteWe Offer Private, Commercial and Personal Loans with very Minimal annual Interest Rates as Low as 3% . We give out loans within the range of $1,000 to $100,000,000.If you are interested reply me now.Contact us via Email: capitalfundings3@gmail.com
ReplyDeleteHello Everybody,
ReplyDeleteMy name is Mrs Sharon Sim. I live in Singapore and i am a happy woman today? and i told my self that any lender that rescue my family from our poor situation, i will refer any person that is looking for loan to him, he gave me happiness to me and my family, i was in need of a loan of S$250,000.00 to start my life all over as i am a single mother with 3 kids I met this honest and GOD fearing man loan lender that help me with a loan of S$250,000.00 SG. Dollar, he is a GOD fearing man, if you are in need of loan and you will pay back the loan please contact him tell him that is Mrs Sharon, that refer you to him. contact Dr Purva Pius,via email:(urgentloan22@gmail.com) Thank you.
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Managements
Email Kindly Contact: (urgentloan22@gmail.com)
Hello Everybody,
ReplyDeleteMy name is Mrs Sharon Sim. I live in Singapore and i am a happy woman today? and i told my self that any lender that rescue my family from our poor situation, i will refer any person that is looking for loan to him, he gave me happiness to me and my family, i was in need of a loan of S$250,000.00 to start my life all over as i am a single mother with 3 kids I met this honest and GOD fearing man loan lender that help me with a loan of S$250,000.00 SG. Dollar, he is a GOD fearing man, if you are in need of loan and you will pay back the loan please contact him tell him that is Mrs Sharon, that refer you to him. contact Dr Purva Pius,via email:(urgentloan22@gmail.com) Thank you.