van de Ven W, Rutten F
Institute for Health Care Policy and Management, Erasmus University, Rotterdam.
Aust Health Rev. 1995;18(1):9-27.
In many European countries health care reforms are taking place. The guiding principle of the reforms is 'more market, less government'. In 1988 the Dutch Government launched proposals for the most radical market-oriented reform in Western Europe. The proposed system can be described as a national health insurance based on regulated competition among both insurers and providers of health care. It can be seen as an ingenious attempt to combine the 'efficiency' of competitive arrangements in the markets for health care and health insurance with the 'equity' of finance through predominantly income-related premiums (National Economic Research Associates 1993). Similar reforms have been proposed and discussed in other countries. In this paper we will concentrate on lessons that other countries may learn from the Dutch experience. What progress has been made since the proclamation of the reforms six years ago? What new issues and problems have arisen and how can we solve these new problems?
许多欧洲国家正在进行医疗保健改革。改革的指导原则是“更多市场，更少政府”。1988年，荷兰政府提出了西欧最激进的市场化改革提案。提议的体系可描述为一种基于保险商和医疗保健供应商之间规范竞争的国民健康保险。它可被视为一种巧妙的尝试，将医疗保健市场和健康保险市场竞争安排的“效率”与通过主要与收入相关的保费实现的融资“公平性”结合起来（国家经济研究协会，1993年）。其他国家也提出并讨论了类似的改革。在本文中，我们将专注于其他国家可以从荷兰经验中学到的教训。自六年前改革宣布以来取得了哪些进展？出现了哪些新问题，我们如何解决这些新问题？
