I haver seen the future of healthcare in Europe and it works. Read our interview with Jan Maarten van den Berg, an inspector with the Inspectie voor de Gezondheidszorg to find out more.

I interviewed van den Berg in order to understand much more clearly how processes can be measured and quality levels defined. At the back of my mind is the question - are quality measurements really possible or do they merely create an extra layer of wasteful bureaucracy and fudge?

Two lessons come out loud and clear. Firstly, quality can be massively improved. The Dutch have halved mortality rates through an iterative process in which procedures are measured and then defined and then improved through further measurements. They are applying the same rigour to more general measurements, such as bed sores. The system works only when you have the consensus of the medical profession combined with rigourous inspections. The Dutch inspectors can and do arrive at 7.45 unannounced.

The second conclusion is far more contentious.But if most (and an increasing number) of healthcare services and procedures can be defined and measured for quality and price then you can create tradeable markets. Such a market already exists in the Netherlands and prices in this sector have not increased in six years.  The Dutch are now pushing on to move 90% of procedures into this market within 4-5 years.

Let me repeat those achievements again. Mortality? Halved. Prices? Not risen in six years.

Similar initiatives exist elsewhere. German insurers are moving towards selective contracting although so far on only around 5% of their business. Swiss insurers such as Helsana are aching to do the same once DRGs are introduced.

What does this mean for private operators?  It should mean that they will increasingly be able to compete in an open market on quality and, if qualityy can be measured accurately and well, on price.