As the United States moves toward health reform, it can glean important insights from other countries. Germany and the Netherlands, in particular, offer rich examples of approaches that could be applied to U.S. institutions. Both provide universal coverage within health systems that rely on competing insurance plans and largely private delivery systems. Both have used similar strategies to address issues and concerns, including insurance boards and exchanges to handle risk, set standards, and facilitate meaningful choice; all-payer payment mechanisms that ensure coherence and prevent undue use of market power; and information systems that inform payment and provide benchmarks to improve overall system performance. Using analysis from experts, as well as visits to both countries to study the systems, this report examines the system oversight and governance mechanisms in both countries to bring insights to the U.S. health reform debate.
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