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Competition among health insurance organizations operating within the compulsory health insurance systems of foreign countries

Vol. 22, Iss. 8, FEBRUARY 2016

PDF  Article PDF Version

Received: 2 November 2015

Accepted: 18 November 2015

Available online: 28 February 2016

Subject Heading: Insurance

JEL Classification: G22, I13

Pages: 35-45

Furman E.V. Moscow University for Industry and Finance ‘Synergy’, Moscow, Russian Federation
evgenij-furman@yandex.ru

Subject The article considers health insurance organizations operating in compulsory health insurance systems and vying for capturing the insured persons and health service quality (the German and Dutch experience).
     Objectives The study aims to determine the place of competition on health service quality among health insurance organizations of compulsory health insurance systems of foreign countries, to define conditions promoting the competition on attracting the insured persons in the said systems.
     Methods Using abstract and logical methods of research, I determined the place and conditions of competition on attracting the insured persons among health insurance organizations involved in compulsory health insurance systems of foreign countries.
     Results The findings show that the compulsory health insurance systems of Germany and the Netherlands have conditions for competition development among health insurance organizations on attracting clients. The competition serves to stimulate these organizations to search for the best balance of price and quality of medical services rendered within the compulsory health insurance system.
     Conclusions In the course of creating the conditions for competition among health insurance organizations operating in the compulsory health insurance system of the Russian Federation, it is advisable to use the experience of Germany and the Netherlands in the promotion of competition on health service quality among relevant insurance organizations. Competition will ensure, in the best possible way, the engagement of health insurance organizations in improving the quality and reducing the price of medical care delivered to the insured persons under the compulsory health insurance scheme.

Keywords: compulsory health insurance, health maintenance organization, framework contract, competition, health service quality

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