The Dutch health insurance reform: consumer mobility.

On 1 January 2006, a number of far-reaching changes in the Dutch health insurance system came into effect. There is now one type of health care insurance for all. The standard package is compulsory for everyone who lives in The Netherlands or pays wage tax in The Netherlands. In the new system of managed competition consumer mobility plays an important role. Consumers are free to change their insurer and insurance plan every year. The idea is that consumers who are not satisfied with the premium or quality of care provided will opt for a different insurer. This would force insurers to strive for good prices and quality of care for their insured. Internationally, the Dutch changes are under the attention of both policy makers and researchers. The first question asked in our research was ‘How mobile are consumers in the new system?’ and the second ‘Are there differences between the general population and specific groups like the chronically ill and disabled?’ Methods: Questions were asked to the Dutch Health Care Consumer Panel, a cross section of the Dutch population (N ¼ 1565), and the National Panel of the Chronically ill and Disabled (N ¼ 3800) in December 2005 and April 2006. Among other things, they were asked about their choices for insurer and insurance plan and the reasons for their choice. Results: Preliminary results from the Consumer Panel show that ±25% of the population switched from insurer. This is far more than could be expected based on consumer mobility in the old system. Reasons for switching can be found in collective offers and the level of premiums. These reasons are probably related, because collective offers come with a discount. Conclusions: As far as the general population is concerned there is increased mobility in the new system. This, however, was not based on considerations of quality of care. People seem to simplify their choice by comparing premiums or by choosing from collective offers, thus limiting the options. The chronically ill and disabled could be confronted with more barriers and, therefore, be less mobile. This is currently being investigated. Furthermore, it could be questioned whether the increased mobility will continue in the future or whether it was just a one-time event, triggered by mass media attention. (aut. ref.