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Translating Dutch: challenges and opportunities in reforming health financing in Ireland

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Abstract

In 2006, Dutch authorities introduced a new health financing system of compulsory private for-profit insurance with strong government regulation. This system has recently attracted attention in Ireland. This paper assesses the theoretical arguments and evidence for applying the Dutch ideas to Ireland. In particular, the authors address how it would help the stated health system policy objectives of improving value for money, fairness and capacity. While the current Dutch reform is still a work in progress, it offers the headline attraction of a single tier system with few waiting lists. Nevertheless, the Dutch system of managed competition may entail risks for Ireland relating to ensuring sufficient system capacity, protecting those on low-incomes and ensuring cost control.

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Notes

  1. Citizens who have not enrolled face harsh penalties.

  2. Community rating means that insurers must charge the same premium for the same coverage irrespective of the enrollee’s age, health or income. Premiums are determined by the region’s health and demographic profile, and the cost of health care.

  3. The acute hospital bed figures relate to 2005.

  4. In 2005 total tax receipts comprised 39.1% of GDP in the Netherlands compared to 30.6% in Ireland [23].

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Authors and Affiliations

  1. Centre for Health Policy and Management, Trinity College Dublin, 3-4 Foster Place, College Green, Dublin 2, Ireland

    P. Ryan, S. Thomas & C. Normand

Authors
  1. P. Ryan
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  2. S. Thomas
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  3. C. Normand
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Correspondence to S. Thomas.

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Ryan, P., Thomas, S. & Normand, C. Translating Dutch: challenges and opportunities in reforming health financing in Ireland. Ir J Med Sci 178, 245–248 (2009). https://doi.org/10.1007/s11845-009-0365-x

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  • DOI: https://doi.org/10.1007/s11845-009-0365-x

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