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Private incentives within and privatization of (mental) health care

Private incentives within and privatization of (mental) health care. A framework for the debate. Delivered at invitational conference Mental Health Care Providers Association of the Netherlands. Amsterdam/Eerbeek, 3 December 2002 S.P.M. de Waal Partner Boer & Croon/Public SPACE.

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Private incentives within and privatization of (mental) health care

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  1. Private incentives within and privatization of (mental) health care A framework for the debate Delivered at invitational conference Mental Health Care Providers Association of the Netherlands Amsterdam/Eerbeek, 3 December 2002 S.P.M. de Waal Partner Boer & Croon/Public SPACE

  2. Current Steering in Care (Netherlands) • Much legislation, little formal room for private initiative • Bureaucratic planning of standardized supply, independent of demand • Stringent and scarce due to non-care policies (tax burden) • Sector itself very collectively organized Disappearance of citizen’s trust Demotivation of employees Slow progress of system changes New policy is ‘too little, too late’ 0.1/SWA/GGZ NL

  3. Strong Forces Press upon this System • Health Care is not just cost, but also investing: • Economic development • Prevention • Actual purchasing power increases and ‘leaks’ beyond public scarcity: • Pensions • Employers • Buying power of citizens and their priorities Current Care Steering Competition on the job market is cutthroat Modern patient wants another type of care (consumerism) Public funding and national planning will never allow for all demands (volume, customized, speed, community effectiveness) 0.1/SWA/GGZ NL

  4. Big Political Choices Needed • Funding Ownership Only state-owned State/private organizations Only private organizations Only public • Profit and/or non-profit: difference? • Competition or planning & monopolies • Concession criteria and inspection and good governance • European regulation on open market Public/private • Voucher systems • Separation of infra-structure and care production • Compensation for the poor/ disabled et cetera How to guarantee all basic rights in a more flexible and entrepreneurial system? Only private 0.1/SWA/GGZ NL

  5. The Third Model which Holland Has Successfully Built Citizen support Public funding Market income Financial resources Ploughing back Share-holders • Donations • Legacies • Volunteering • Member payments Organizations Civil enterprise Government organization Commercial enterprise 0.1/SWA/GGZ NL

  6. In the Meantime There Is Much Room for Entrepreneurship… • Current strategies (non-exclusive): • Corporate merging: regional monopolies, negotiating power, economies of scale and services • vertical integration • horizontal integration • Small scale and community based services • Commercial services within regional public monopoly • Services abroad Government/purchaser Civilenterprise Citizen Market 0.1/SWA/GGZ NL

  7. …and for New Enterprises • Current strategies • Cost cutting: easy jet health care (not very common) • Differentiation • Niche markets • National franchise formula • Focus: specializing and dedicated organization (volume AND top care) Government Purchaser Commercial enterprise Regular public organization Consumer Substitutes 0.1/SWA/GGZ NL

  8. Present Challenges • Value for money • efficiency • effectiveness • Chainless care • Community care • Health responsibility and prevention • Good governance • Consumer power • NGO’s • legislation and law suits • e-power • Solving public problems • addiction • forensic care • homeless • fugitives • Typical policy instruments like: • performance measurement • output financing • benchmarking • neutral indication 0.1/SWA/GGZ NL

  9. Public SPACE is een initiatief van Boer & Croon Boer & Croon Corporate Strategy Adviseert topmanagement over strategie en complexe organisatieverandering Boer & Croon Executive Managers Voorziet op tijdelijke basis in ervaren en onafhankelijke eindverantwoordelijke managers Boer & Croon Corporate Communication Maakt communicatie op het hoogste organisatieniveau bespreekbaar, beslisbaar en verankerbaar Boer & Croon Corporate Finance+ Begeleidt fusies en samenwerkingen. Doet waardebepaling en zoekprocessen naar kandidaten en helpt bij de integratie Boer & Croon Process Managers Stuurt en begeleidt complexe veranderings- en besluitvormingsprocessen Boer & Croon Professional Governance Voorziet in voorzitters en leden van raden van commissarissen en raden van toezicht Public SPACE Internationaal advies- en onderzoekscentrum op het gebied van Strategies for Public And Civil Entrepreneurs InterMaat Masters in Change Voorziet op tijdelijke basis in veranderingsmanagers, projectmanagers en functionele managers Academy for Young Executives Management development programma voor jong talent NeXtrategy Ontwerpt en implementeert internet- en e-business strategieën EIM Executive Interim Management Joint Venture met Egon Zehnder. EIM is ons netwerk van management- en advieskantoren in Europa, de Verenigde Staten en Australië Bij Boer & Croon zijn in Nederland circa 300 professionals werkzaam en in Europees verband circa 150 professionals 0.1/SWA/GGZ NL

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