The effect of market reforms and new public management mechanisms on the Swiss health care system.

ABSTRACT

In 1996, the Federal Law on Health Insurance (LAMal) was adopted in order to contain costs in Swiss health care. At the same time, the reform aimed to maintain or even improve solidarity and encourage institutional reform through new public management (NPM) and market mechanisms. More freedom in contractual conditions between insurers and providers and a clearer distinction of responsibilities between federal and regional (cantonal) authorities were stipulated to achieve efficiency, effectiveness, and transparency. The focus of this paper is an analysis of the effects of market reforms and NPM mechanisms introduced with the LAMal on the cost-containment, quality of care and equity objectives in the Swiss health care system.