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Health Insurance Values and Implementation in the Netherlands and the Federal Republic of Germany
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1991
Year
Mutual ObligationsComparative Health SystemsHealth Insurance ValuesHealth Insurance DesignMutual ResponsibilityHealth ReformHealthcare ProvisionHealth PoliticsHealth Care FinanceHealth GovernanceHealth System AnalysisPrivate PartiesHealth FinancingPublic HealthFederal RepublicInsuranceHealth Services ResearchUniversal Health CareHealth Insurance ReformPublic PolicyHealth PolicyHealth InsuranceNational Health InsuranceSingle-payer Health InsuranceHealth SystemsMedical EthicsHealth Economics
The health care systems in the Netherlands and the Federal Republic of Germany are based on a set of values that involve mutual obligations between private parties. These obligations are realized through systems incorporating private practice physicians, community and church- and municipality-affiliated hospitals, and nonprofit and for-profit insurers. The underlying values and implementation approaches in these systems provide an alternative to the adoption of a Canadian-style health insurance system. A discussion that focuses on "obligations" rather than "rights" may be a more useful approach for the design of reforms of the American health system in the 1990s. Such a discussion would focus on the mutual responsibility of all parties to create and maintain a universal private health care system. (<i>JAMA</i>. 1991;265:2496-2502)