Biomedical Engineering Reference
In-Depth Information
12.3.2.2 Health-Care Insurances
Since 2006, the difference between public and private health insurance has
been abolished in the Netherlands (Healthcare IT Management 2007). Every
adult citizen is obliged to purchase the basic health-care insurance policy.
This service is available to all Dutch citizens, and the content of different
services covered in this policy is regulated by the government. This ensures
access to adequate health-care services for all Dutch citizens. For supplemen-
tary services, health-care insurance companies have a free hand in putting
together services, what it should cost, and to whom it is provided.
With the rise of technological possibilities (such as the BAN concept) and
the opportunities it promises to increase efficiency in health care (in terms of
costs and quality of life), the incentive for the health-care insurances to invest
in such technologies is growing. A possible role envisioned for the health-
care insurance companies is the provision (or investing in and the setup
of) of health-care services connected to BAN technologies (or tele-health in
general). In fact, some health-care insurance companies in the Netherlands
are already experimenting with tele-health technology pilot settings (cf.
Motiva Project). Call centers and medical consultancy services connected
to health-care professionals are a necessary foundation of such technol-
ogies where continuous data uptake, storage, monitoring, and analysis can
take place. According to the medical professionals we have interviewed,
health-care insurance companies have incentives to invest in such service
centers because the information generated there can open new opportunities
to implement control mechanisms. Different strategies can be obtained by
health-care insurances in the future, such as the reward system. On the one
hand, patients might be offered to benefit from discounts in exchange of loss
of privacy, and on the other hand they would hand over control over their
lifestyle because they give away control through provision of their medical
data. The pressure to control the spiraling costs of health care together with
the new technological possibilities might also open up new opportunities
for health-care insurances to develop strategies toward an output-driven
financial infrastructure for health care. In other words, this will provide
health-care insurance companies a much better control over their long-term
financial investments and expenditures.
There are different expectations with regard to the possibility of use of
information management systems in health care through which the quality
of care provision can be monitored and steered if necessary. The possibili-
ties to compare the quality of services of health-care professionals, institu-
tions, and facilities through analysis of a set of indicators are progressively
growing. The argument is that comparative analysis will increase awareness
on quality issues for health-care institutions, increase competitiveness, and
thereby maintain the quality of care at high standards (KPN 2006). From a
societal perspective, a more critical elaboration is needed on the selection
of criteria on the basis of which such comparisons are made. Furthermore,
