Stuck in the middle? A perspective on ongoing pro-competitive reforms in Dutch mental health care

Daan Westra*, Gloria Wilbers, Federica Angeli

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Pro-competitive reforms have been implemented in many Western healthcare systems, of which the Netherlands is a prominent example. While the pro-competitive reforms in the Dutch specialized care sector have drawn considerable academic attention, mental health care is often excluded. However, in line with other segments of specialized care, pro-competitive legislation has formed the core of mental health care reforms, albeit with several notable differences. Ever since mental health services were included in the Health Insurance Act in 2008, the Dutch mental healthcare sector has been in an ongoing state of reform. Numerous major and minor adaptations have continuously altered the services covered by the basic insurance package, the actors responsible for providing and contracting care, and definitions and measurements of quality. Most notably, insurers and municipalities, which are responsible for selectively contracting those providers that offer high value-for-money, seem insensitive to quality aspects. The question whether the Dutch mental health sector has inherited the best or the worst of a competitive and noncompetitive system lingers and international policy makers contemplating reforming their mental health sector should take note.
Original languageEnglish
Pages (from-to)345-349
JournalHealth Policy
Volume120
Issue number4
DOIs
Publication statusPublished - Apr 2016

Keywords

  • Health care reform
  • Mental health services
  • Psychiatric services
  • Managed competition
  • Quality of health care
  • Health policy
  • Netherlands

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