Manifesto opposes introduction of market forces into Dutch health care
http://www.100md.com
《英国医生杂志》
Nearly 40 medical professors, doctors, and hospital managers have signed a manifesto opposing the introduction of market forces into Dutch health care. Care For Everyone, the initiative of epidemiologist and opposition MP Agnes Kant, appeared as parliament debated reforms to establish a market of competing health insurers.
The manifesto has garnered support beyond her Socialist Party and sparked a debate over market reforms set to start on the 1 January.
It raises concerns that competition will prevent hospitals from cooperating to reduce waiting lists, increase the cost of scarce treatment, and reduce quality, if care is offered at the lowest price. "Sick patients cannot wait three weeks while they investigate what is the best product," the manifesto argues.
Signatories to the manifesto include such names as Dr Wim van den Brink, professor of clinical epidemiology and addiction care at the Academic Medical Centre, Amsterdam, Jaap van den Heuvel, general manager of the Red Cross Hospital north of Amsterdam, and Dr Bas Vos, chairman of the GPs?association. Also included are senior editors of three medical and scientific journals including Medisch Contact, published by the Dutch Medical Association.
Its senior editor, Dr Ben Crul, a former GP, said that people were not against every market incentive but rather, " the holy belief of minister Hoogervorst that if you let doctors and health insurers compete then everything will be better and cheaper."
"If doctors compete with each other it is ultimately bad for health care," he argued, saying that it would damage the chain of care from the GP to hospital specialist. "The market might work for a simple patient with a cataract operation, but a heart patient who is overweight with diabetes and kidney problems梩hat is a completely different story."
Health minister Hans Hoogervorst dismissed the manifesto as "patronising" patients, most of whom are healthy payers of premiums, "critical consumers of care" who will search for the cheapest insurance and the best hospitals.
In a joint statement the medical specialists body and the patients federation described the manifesto as well intentioned but ill conceived. They argue that market forces may not be a "panacea" but that "choice," "genuine pricing," "freedom for providers," and "limited competition" is desirable. Rob Dillmann, director of the Association of Medical Specialists, has argued that central planning and budgeting has led to stagnation in Dutch health care. Improvements are essential and market forces have a role to play.
Under the reforms, hospitals and insurance companies will begin to negotiate on the cost and quality of some elective surgery such as knee, hip, and cataract operations, priced under a system of diagnostic treatment combinations, from 2005.
This will be followed in 2006 by the introduction of a standard health insurance package and premium for everyone, abolishing the current split between private and national health and allowing insurance companies to compete better for patients. Patients can choose a new insurance company each year.(Utrecht Tony Sheldon)
The manifesto has garnered support beyond her Socialist Party and sparked a debate over market reforms set to start on the 1 January.
It raises concerns that competition will prevent hospitals from cooperating to reduce waiting lists, increase the cost of scarce treatment, and reduce quality, if care is offered at the lowest price. "Sick patients cannot wait three weeks while they investigate what is the best product," the manifesto argues.
Signatories to the manifesto include such names as Dr Wim van den Brink, professor of clinical epidemiology and addiction care at the Academic Medical Centre, Amsterdam, Jaap van den Heuvel, general manager of the Red Cross Hospital north of Amsterdam, and Dr Bas Vos, chairman of the GPs?association. Also included are senior editors of three medical and scientific journals including Medisch Contact, published by the Dutch Medical Association.
Its senior editor, Dr Ben Crul, a former GP, said that people were not against every market incentive but rather, " the holy belief of minister Hoogervorst that if you let doctors and health insurers compete then everything will be better and cheaper."
"If doctors compete with each other it is ultimately bad for health care," he argued, saying that it would damage the chain of care from the GP to hospital specialist. "The market might work for a simple patient with a cataract operation, but a heart patient who is overweight with diabetes and kidney problems梩hat is a completely different story."
Health minister Hans Hoogervorst dismissed the manifesto as "patronising" patients, most of whom are healthy payers of premiums, "critical consumers of care" who will search for the cheapest insurance and the best hospitals.
In a joint statement the medical specialists body and the patients federation described the manifesto as well intentioned but ill conceived. They argue that market forces may not be a "panacea" but that "choice," "genuine pricing," "freedom for providers," and "limited competition" is desirable. Rob Dillmann, director of the Association of Medical Specialists, has argued that central planning and budgeting has led to stagnation in Dutch health care. Improvements are essential and market forces have a role to play.
Under the reforms, hospitals and insurance companies will begin to negotiate on the cost and quality of some elective surgery such as knee, hip, and cataract operations, priced under a system of diagnostic treatment combinations, from 2005.
This will be followed in 2006 by the introduction of a standard health insurance package and premium for everyone, abolishing the current split between private and national health and allowing insurance companies to compete better for patients. Patients can choose a new insurance company each year.(Utrecht Tony Sheldon)