{"id":130,"date":"2013-03-23T20:30:00","date_gmt":"2013-03-24T00:30:00","guid":{"rendered":"http:\/\/blog.cmhughesmd.com\/?p=130"},"modified":"2013-03-23T20:30:00","modified_gmt":"2013-03-24T00:30:00","slug":"nejm-netherlands-and-managed-competition","status":"publish","type":"post","link":"http:\/\/blog.cmhughesmd.com\/?p=130","title":{"rendered":"NEJM \u2014 Netherlands and Managed Competition"},"content":{"rendered":"<p><a href=\"http:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMp1106090?viewType=Print#.UU5I-rA8Ifk.blogger\">NEJM \u2014<\/a><\/p>\n<blockquote><p>The myth that competition has been key to cost containment in the  Netherlands has obscured a crucial reality. Health care systems in  Europe, Canada, Japan, and beyond, all of which spend much less than the  United States on medical services, rely on regulation of prices,  coordinated payment, budgets, and in some cases limits on selected  expensive medical technologies, to contain health care spending.<span><a href=\"http:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMp1106090?viewType=Print#ref5\" rel=\"#refLayer\">5<\/a><\/span>  Systemwide regulation of spending, rather than competition among  insurers, is the key to controlling health care costs. The Netherlands,  after all, spent much less on medical care than the United States with  virtually universal insurance coverage long before it began  experimenting with managed competition in 2006.<\/p><\/blockquote>\n<blockquote><p>The Dutch  experience provides a cautionary tale about the place of private  insurance competition in health care reform. The Dutch reforms have  fallen far short of expectations \u2014 a reminder that policy intentions  should not be confused with outcomes and that managed competition is  hardly a panacea. The idea that the Dutch reforms provide a successful  model for U.S. Medicare to emulate is bizarre. The Dutch case in fact  underscores the pitfalls of the casual use (and misuse) of international  experience in U.S. health care reform debates.<span><a href=\"http:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMp1106090?viewType=Print#ref5\" rel=\"#refLayer\">5<\/a><\/span> Before we learn <i>from<\/i> other countries&#8217; experiences with medical care, we first need to learn <i>about<\/i> them.<\/p><\/blockquote>\n","protected":false},"excerpt":{"rendered":"<p>NEJM \u2014 The myth that competition has been key to cost containment in the Netherlands has obscured a crucial reality. Health care systems in Europe, Canada, Japan, and beyond, all &hellip; <a href=\"http:\/\/blog.cmhughesmd.com\/?p=130\" class=\"more-link\">Continue reading<span class=\"screen-reader-text\"> &#8220;NEJM \u2014 Netherlands and Managed Competition&#8221;<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"sfsi_plus_gutenberg_text_before_share":"","sfsi_plus_gutenberg_show_text_before_share":"","sfsi_plus_gutenberg_icon_type":"","sfsi_plus_gutenberg_icon_alignemt":"","sfsi_plus_gutenburg_max_per_row":"","footnotes":""},"categories":[26],"tags":[],"class_list":["post-130","post","type-post","status-publish","format-standard","hentry","category-private-health-insurance"],"post_mailing_queue_ids":[],"_links":{"self":[{"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=\/wp\/v2\/posts\/130","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=130"}],"version-history":[{"count":0,"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=\/wp\/v2\/posts\/130\/revisions"}],"wp:attachment":[{"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=130"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=130"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=130"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}