Health care systems around the world are evolving into increasingly complex markets that are often no longer confined to national borders. Market forces play a major role in the organization and provision of health care. Examples of market forces include a larger role for financial incentives in a particular health system or emerging public-private partnerships. However, it is widely acknowledged that the free play of market forces can have negative consequences for the quality of - and equal access to - health care in both developing and developed nations.

Many countries in the European Community have introduced extensive supply-side regulation to counteract the possible negative consequences of evolving market forces. However, in recent years they have started a process of reform to allow for a more demand-led approach to health care provision. While traditional forms of regulation are being abolished, new regulation aims to: regulate health care markets; improve quality of care with a more active role of inspectorates; and focus on patient rights and the role of patients as consumers of health care. 
ECORYS is ideally placed to advise on the design and implementation of these new types of policies given our extensive health care experience combined with in-house expertise on deregulation and competition in both the health sector and other sectors such as utilities.

More information
For more information, please contact:

Arthur ten Have
Partner Health
T +31 (0)10 453 86 82
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Wija Oortwijn
Partner Health
T +31 (0)10 453 84 21
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Project references

Project: Study on the competitiveness of the EU market and industry for pharmaceuticals
Country: European Union
Client: European Commission
Activities: The study had a dual purpose. First, the market for pharmaceuticals was monitored to establish facts and to verify the causes of the alleged underperformance of the market. Understanding of how the market functions in various Member States is an essential cornerstone to policy making across Europe. The study’s second and related purpose was associated with the fact that the market for pharmaceuticals is a key sector for Europe, and its performance is vital for Europe’s competitiveness.

Project: Study on the regulatory restrictions in the field of pharmacies
Country: European Union
Client: European Commission
Activities: The study analysed how rules applicable to community pharmacies (including self-regulation) in the different Member States affect structure and conduct in the market for community pharmacy services and how this eventually influences the quality of services provided by community pharmacists (pharmacies). In addition, the impact of these regulations on the functioning of the internal market was analysed.

Project: Governance in semi-public organizations: what lessons can be learned?
Country: The Netherlands
Activities: This study aimed to provide an overview of governance of organizations in semi-public sectors in the Netherlands. Three sectors were analyzed: housing, health care (hospitals) and primary education. Experiences in foreign countries were studied to get an indication to what extent governance in the Netherlands differs from other countries and to learn lessons from good semi-public governance. In the last few years the Dutch government has decentralised many responsibilities to health care institutions. To find opportunities for improvement, governance of Dutch hospitals was compared with governance of hospitals in Germany, Switzerland, the United States and the United Kingdom.

Project: Client’s models and regulations in the provision of long-term care
Country: The Netherlands
Client: Ministry of Economic Affairs
Activities: In the Netherlands consumers can either choose to receive long-term care (services) or a personal budget (PGB) that can be used to buy the care they need (client model). In 2009, health insurance companies were made responsible for long-term care in the Netherlands. The Ministry of Economic Affairs asked ECORYS to investigate how a client model interacts with a model of regulated competition.

Project: Transparency of economic choices in Dutch health care
Country: The Netherlands
Client: Dutch Patient and Consumers Platform
Activities: ECORYS experts determined the factors influencing hospital costs in the period 2000-2007 to explain why hospital costs tend to be larger than budgeted and agreed between Government, health insurers and hospitals. In a separate study an evaluation was made of the impact of a new tariff system for general practitioners that was recently introduced.