Market forces in healthcare insurance: The impact of healthcare reform on regulated competition revisited

Abstract The Dutch healthcare insurance reform in 2006 replaced the dual system of public and private with a single compulsory health scheme, which providers compete for customers free market. This paper investigates whether competition among insurers has indeed increased their efficiency improved. We measure directly from either shifts market shares, or developments profits, using regulatory data. find that structural break occurs after reform: is significantly higher than before. holds both analysis based on shares profits. Several robustness tests confirm this outcome. Hence, had significant impact. Nevertheless, we sector still less competitive financial sectors such as banking life insurance.