International Journal of Health Policy and Management

International Journal of Health Policy and Management

Why Must We Keep Discussing Strategic Purchasing and Managed Competition?; Comment on “Measuring Active Purchasing in Healthcare: Analysing Reallocations of Funds Between Providers to Evaluate Purchasing Systems Performance in the Netherlands”

Document Type : Commentary

Author
Scott L. Greer 1, 2
1 School of Public Health, University of Michigan-Ann Arbor, Ann Arbor, MI, USA
2 European Observatory on Health Systems and Policies, Brussels, Belgium
10.34172/ijhpm.9248
Abstract
Stadhouders and colleagues’ new measure answers an important question: Do strategic purchasing and managed competition redirect healthcare resources, and, if so, when, how, and to what? Applying it to the Netherlands, they find that they do not. This commentary first examines logical problems in arguments for strategic purchasing and managed competition, and then briefly reviews other evidence of their very limited success from, in particular, the Netherlands and England. It then raises the question of why strategic purchasing and managed competition continue to be advocated despite the poor logic of the arguments behind them and substantial evidence that they do not work.
Keywords
Strategic Purchasing
Managed Competition
Netherlands
England
Payment Systems
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International Journal of Health Policy and Management
Volume 14, Issue 1
2025
Pages 1-3

  • Received Date 29 May 2025
  • Revised Date 11 July 2025
  • Accepted Date 13 July 2025
  • First Published Date 14 July 2025
  • Published Date 01 December 2025