Implementing insurance exchanges: U.S. policy makers can learn from Europe

A key part of the healthcare reforms in the Affordable Care Act are state-based health insurance exchanges. Beginning in January 2014 individuals and small employers will be able to compare and purchase health plans through their state’s exchange. The intent is that the exchanges will boost cost containment by encouraging competition among insurers.

Policy makers can learn some “cautionary lessons” from the experiences of the Netherlands and Switzerland, where exchanges have been in place for some time,  wrote Katherine Swartz, professor of health policy and economics at Harvard School of Public Health (HSPH), and Ewout van Ginneken, Harkness Fellow in HSPH’s Department of Health Policy and Management, in the August 23, 2012, New England Journal of Medicine (NEJM). The article, entitled, “Implementing Insurance Exchanges – Lessons from Europe,” was the subject of a Washington Post blog on August 23.

“The experience of Switzerland and the Netherlands suggests that reforms involving the provision and purchasing of health care are needed along with health insurance exchanges,” Swartz and van Ginneken wrote.

Read the NEJM article

Read the Washington Post article

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