Health insurance values and implementation in The Netherlands and the Federal Republic of Germany. An alternative path to universal coverage
B. L. Kirkman-Liff
School of Health Administration and Policy, College of Business, Arizona State University, Tempe 85287-4506.
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.
