Choice of health insurer and healthcare provider

Consumer choice of health insurer is an essential precondition for achieving efficiency and consumer responsiveness in healthcare. In healthcare, consumer preferences are highly heterogeneous. This implies that if groups of consumers with specific preferences feel not free to switch insurer, insurers have lower incentives to accommodate the specific preferences of these consumers than the preferences of other consumers. This thesis examines whether all groups of consumers with specific preferences feel free to easily switch insurer in the Netherlands and formulates strategies to improve consumer choice of insurer.

If consumers feel free to switch insurer, they will be able to choose the insurance product that best satisfies their preferences. Analysts consider selective contracting with healthcare providers as the main tool that insurers have to stimulate efficiency in healthcare. If consumers are unwilling to give up their unlimited free choice of healthcare provider in return for a lower premium, they will not take out the insurance products with a limited healthcare provider choice. Because the threat of selective contracting will then be substantially reduced for healthcare providers, regulated competition will be less able to enhance efficiency in healthcare. The United States were confronted with a substantial backlash against selective contracting. The thesis evaluates the causes of this backlash and seeks lessons for Dutch insurers and policymakers.