2014-2015 ACM Agenda

Health Care Consumers

Several developments in the health care market are affecting consumers directly or indirectly such as the functioning of the health insurance market, hospital mergers, municipalities that are assigned responsibility for buying health care, unnecessarily expensive drugs, and false health insurance claims filed by health care providers.

ACM’s role

Public attention to health care is high. One of the reasons is that we all spend a lot on health care. ACM’s goal is to offer consumers the best opportunities and options in health care by taking action against impediments to competition.

Collaborations that aim to realize and lead to the best opportunities and options are thus good for consumers. ACM believes it is important that health care providers feel they have enough room for cooperation. ACM can take action in situations where collaborations not necessarily serve the interests of consumers, but primarily the interests of the health care providers themselves, thereby leading to harmful effects. With the online consultation, ACM wanted to hear from the market what problems consumers, health care providers, health insurers and other stakeholders were facing, and what role ACM could play in solving those problems.

Results of the online consultation

For six weeks, ACM put five provocative statements and two polls online. Participation in the discussion by patients and health insurers was very limited. Paramedics in particular joined the discussion about health care consumers.

According to several participants in the forum discussion, there are no arrangements between health care providers that hinder patients in their freedom of choice. Respondents felt that the statement that health care providers made arrangements on, for example, sharing patients and services, which are not in the interest of patients, was not a reflection of the real world.

In addition, participants said they did not experience any barriers to establishing themselves as health care provider. However, low (or too low) reimbursements by health insurers stand in the way of high-quality care and investments in innovation, according to the paramedics. They said that health insurers predominantly buy on price rather than on quality.

According to the participants in the discussion, ACM should focus primarily on the promotion of cooperation between health care providers.

Follow-up steps

ACM finds it important that health care providers are able to cooperate, as long as such collaborations are in the interest of consumers, for example, if the quality of treatments increases, or if health care costs decrease (and thus premiums as well).

In 2013, ACM published guidelines on ‘Assessing mergers and collaborations in hospital care.’ ACM will publish similar guidelines for primary care, mental health care, long-term care, and youth welfare, too. In these new guidelines, ACM will incorporate the responses it received during the consultation from independent health care providers such as speech therapists and physiotherapists. With these guidelines, ACM wishes to offer clarity about the kinds of initiatives that are allowed, because they are in the interests of patients, and which initiatives are not. ACM expects to release these new guidelines sometime later this year.

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