Health Care Analysis

, Volume 14, Issue 1, pp 37–49 | Cite as

Consumer Choice in Dutch Health Insurance after Reform

  • Hans MaarseEmail author
  • Ruud Ter Meulen
Original Paper


This article investigates the scope and effects of enhanced consumer choice in health insurance that is presented as a cornerstone of the new health insurance legislation in the Netherlands that will come into effect in 2006. The choice for choice marks the current libertarian trend in Dutch health care policymaking. One of our conclusions is that the scope of enhanced choice should not be overstated due to many legal and non-legal restrictions to it. The consumer choice advocates have great expectations of the impact of enhanced choice. A critical analysis of its impact demonstrates that these expectations may not become true and that enhanced consumer choice should not be perceived as the ‘magic bullet’ for many problems in health care.


Consumer choice Health care reform Health insurance Market competition 


  1. 1.
    CPB (Centraal Planbureau) (2005) Switch on the Competition: Causes, Consequences and Policy Implications of Consumer Switching Costs. The HagueGoogle Scholar
  2. 2.
    Daniels N (2000) Accountability for Reasonableness in Private and Public Health Insurance. In: A. Coulter and C. Ham (eds.), The Global Challenge of Health Care Rationing. Buckingham/ Philadelphia: Open University Press: 89–106Google Scholar
  3. 3.
    De Heij L (2004) Zorgverzekeringswet kan tot minder zorgverbetering leiden. ESB, 9-7-2004:320-321Google Scholar
  4. 4.
    Evans R (1998) Going for the Gold: the Redistributive Agenda behind Market-Based Health Care Reform. In: M.Peterson, Healthy Markets? The New Competition in Medical Care. Durham/London: Duke University Press:66–102Google Scholar
  5. 5.
    Hirschman A (1970) Exit, Voice and Loyalty. Cambridge (Mass): Harvard University PressGoogle Scholar
  6. 6.
    Hirsch F (1977) Social Limits to Growth. London: RoutledgeGoogle Scholar
  7. 7.
    IOO (Instituut voor Onderzoek van Overheidsuitgaven) (2000) Concurrentie tussen particuliere ziektekostenverzekeraars. Den HaagGoogle Scholar
  8. 8.
    Kerssens J, Groenewegen P (2005) Consumer preferences in social health insurance. European Journal of Health Economics 50:8–15CrossRefGoogle Scholar
  9. 9.
    Laske-Aldershof T, Schut F (2002) Switching Behavior of Consumers in Dutch Social Health Insurance, paper presented at the 4th European conference on health economics, ParisGoogle Scholar
  10. 10.
    Laske-Aldershof T, Schut F (2005) Monitor verzekerdenmobiliteit. Rotterdam: iBMGGoogle Scholar
  11. 11.
    Maarse J, Paulus A (2003) Has Solidarity Survived? A Comparative Analysis of the Effect of Social Health Insurance Reform in Four European Countries. Journal of Health Politics, Policy and Law 28(4), 585–614PubMedCrossRefGoogle Scholar
  12. 12.
    Maarse J, Okma K (2004) The Privatisation Paradox in Dutch Health Care. In: J. Maarse (ed), Privatisation in European Health Care. Maarssen: Elsevier: 97–116Google Scholar
  13. 13.
    Maarse H, Paulus A A, Kuiper G (2005) Supervision in Social Health Insurance: a Four-Country Study. Health Policy 71(3), 333–346PubMedCrossRefGoogle Scholar
  14. 14.
    Motta M (2004) Competition Policy. Theory and Practice. Cambridge: Cambridge University PressGoogle Scholar
  15. 15.
    Porter M, Olmsted Teisberg E (2004) Redefining Competition in Health Care. Harvard Business Review, on line version, June ( Scholar
  16. 16.
    Rice T (2001) Should Consumer Choice be Encouraged in Health Care? In: J. Davis (ed.) The Social Economics of Health Care. London: RoutledgeGoogle Scholar
  17. 17.
    Schwartz B (2004) The Paradox of Choice – Why More is Less. Harper Collins PublishersGoogle Scholar
  18. 18.
    Ter Meulen R (1995) Limiting Solidarity in the Netherlands: a Two-Tier System on the Way. Journal of Medicine and Philosophy 20, 607–616Google Scholar
  19. 19.
    Van de Ven W, Ellis R (2000) Risk Adjustment in Competitive Health Policy Markets. In: A. Culyer, J. Newhouse (eds.) Handbook of Health Economics, volume 1A. Amsterdam: Elsevier, chapter 14Google Scholar
  20. 20.
    Van de Ven W, Prinsze F, de Bruijn D, Schut F (2005) Nieuw zorgstelsel vereist betere risicoverevening. Economisch Statistische Berichten 20-5-2005: 223-225Google Scholar
  21. 21.
    Van Dijk M, Pomp M, Laske-Aldershof T, Schut E, Boer W, de Boo A, Smit M (2005) Consumer Price Sensitivity in Social Health Insurance. The Hague: discussion paperGoogle Scholar
  22. 22.
    Vektis (2005) Verzekeringsmonitor ( Accessed July 14, 2005Google Scholar

Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  1. 1.Department Health Organisation, Policy and EconomicsUniversity of MaastrichtMaastrichtThe Netherlands
  2. 2.Centre for Ethics in MedicineUniversity of BristolBristolUK

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