Results of the market-oriented reform in the Netherlands: a review

H. Maarse*, P. Jeurissen, D. Ruwaard

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


The market-oriented reform in the Dutch health care system is now in its 10(th) year. This article offers a concise overview of some of its effects thus far on health insurance, healthcare purchasing and healthcare provision. Furthermore, attention is given to its impact on healthcare expenditures, power and trust relationships as well as the relationship between the Minister of Health and the Dutch Healthcare Authority. The reform triggered various alterations in Dutch health care some occurring quickly (e.g. health insurance), others taking longer (e.g. purchasing). These developments suggest a process of gradual transformation. The reform has instigated controversy which is increasingly framed as a power conflict between insurers and providers. Weakened consumer trust in insurers threatens the legitimacy of the reform. The relationship between Minister and Healthcare Authority appears to be more intimate than the formal independent status of this regulatory agency would suggest.

Original languageEnglish
Pages (from-to)161–178
Number of pages18
JournalHealth Economics, Policy and Law
Issue number2
Early online date17 Aug 2015
Publication statusPublished - Apr 2016



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