Can universal access be achieved in a voluntary private health insurance market? Dutch private insurers caught between competing logics.

2.50
Hdl Handle:
http://hdl.handle.net/10029/621960
Title:
Can universal access be achieved in a voluntary private health insurance market? Dutch private insurers caught between competing logics.
Authors:
Vonk, Robert A A; Schut, Frederik T
Abstract:
For almost a century, the Netherlands was marked by a large market for voluntary private health insurance alongside state-regulated social health insurance. Throughout this period, private health insurers tried to safeguard their position within an expanding welfare state. From an institutional logics perspective, we analyze how private health insurers tried to reconcile the tension between a competitive insurance market pressuring for selective underwriting and actuarially fair premiums (the insurance logic), and an upcoming welfare state pressuring for universal access and socially fair premiums (the welfare state logic). Based on primary sources and the extant historiography, we distinguish six periods in which the balance between both logics changed significantly. We identify various strategies employed by private insurers to reconcile the competing logics. Some of these were temporarily successful, but required measures that were incompatible with the idea of free entrepreneurship and consumer choice. We conclude that universal access can only be achieved in a competitive individual private health insurance market if this market is effectively regulated and mandatory cross-subsidies are effectively enforced. The Dutch case demonstrates that achieving universal access in a competitive private health insurance market is institutionally complex and requires broad political and societal support.
Citation:
Can universal access be achieved in a voluntary private health insurance market? Dutch private insurers caught between competing logics. 2018:1-22 Health Econ Policy Law
Journal:
Health Econ Policy Law 2018; advance online publication (ahead of print)
Issue Date:
7-May-2018
URI:
http://hdl.handle.net/10029/621960
DOI:
10.1017/S1744133118000142
PubMed ID:
29732999
Type:
Article
Language:
en
ISSN:
1744-134X
Appears in Collections:
Miscellaneous

Full metadata record

DC FieldValue Language
dc.contributor.authorVonk, Robert A Aen
dc.contributor.authorSchut, Frederik Ten
dc.date.accessioned2018-05-27T13:20:41Z-
dc.date.available2018-05-27T13:20:41Z-
dc.date.issued2018-05-07-
dc.identifier.citationCan universal access be achieved in a voluntary private health insurance market? Dutch private insurers caught between competing logics. 2018:1-22 Health Econ Policy Lawen
dc.identifier.issn1744-134X-
dc.identifier.pmid29732999-
dc.identifier.doi10.1017/S1744133118000142-
dc.identifier.urihttp://hdl.handle.net/10029/621960-
dc.description.abstractFor almost a century, the Netherlands was marked by a large market for voluntary private health insurance alongside state-regulated social health insurance. Throughout this period, private health insurers tried to safeguard their position within an expanding welfare state. From an institutional logics perspective, we analyze how private health insurers tried to reconcile the tension between a competitive insurance market pressuring for selective underwriting and actuarially fair premiums (the insurance logic), and an upcoming welfare state pressuring for universal access and socially fair premiums (the welfare state logic). Based on primary sources and the extant historiography, we distinguish six periods in which the balance between both logics changed significantly. We identify various strategies employed by private insurers to reconcile the competing logics. Some of these were temporarily successful, but required measures that were incompatible with the idea of free entrepreneurship and consumer choice. We conclude that universal access can only be achieved in a competitive individual private health insurance market if this market is effectively regulated and mandatory cross-subsidies are effectively enforced. The Dutch case demonstrates that achieving universal access in a competitive private health insurance market is institutionally complex and requires broad political and societal support.en
dc.language.isoenen
dc.rightsArchived with thanks to Health economics, policy, and lawen
dc.titleCan universal access be achieved in a voluntary private health insurance market? Dutch private insurers caught between competing logics.en
dc.typeArticleen
dc.identifier.journalHealth Econ Policy Law 2018; advance online publication (ahead of print)en
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