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Health Care Anal (2011) 19:329351
DOI 10.1007/s10728-010-0155-7
ORIGINAL ARTICLE
Hester M. Van de Bovenkamp
Margo J. Trappenburg
Published online: 28 August 2010 The Author(s) 2010. This article is published with open access at Springerlink.com
Abstract Patient organizations increasingly play an important role in health care decision-making in Western countries. The Netherlands is one of the countries where this trend has gone furthest. In the literature some problems are identied, such as instrumental use of patient organizations by care providers, health insurers and the pharmaceutical industry. To strengthen the position of patient organizations government funding is often recommended as a solution. In this paper we analyze the ties between Dutch government and Dutch patient organizations to learn more about the effects of such a relationship between government and this part of civil society. Our study is based on ofcial government documents and existing empirical research on patient organizations. We found that government inuence on patient organizations has become quite substantial with government inuencing the organizational structure of patient organizations, the activities these organizations perform and even their ideology. Financing patient organizations offers the government an important means to hold them accountable. Although the ties between patient organizations and the government enable the former to play a role that can be valued as positive by both parties, we argue that they raise problems as well which warrant a discussion on how much government inuence on civil society is acceptable.
Keywords Civil society Government inuence Health care decision-making
Patient organizations
H. M. Van de Bovenkamp (&)
Institute of Health Policy and Management, Erasmus University Rotterdam, Postbus 1738, 3000 DR Rotterdam, The Netherlandse-mail: [email protected]
M. J. Trappenburg
Utrecht School of Governance, Utrecht University, Utrecht, The Netherlands
M. J. Trappenburg
University of Amsterdam, Amsterdam, The Netherlands
Government Inuence on Patient Organizations
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Introduction
In the last two decades many western welfare states have granted their citizens more choice and more inuence in the provision of public services (housing, education, home help, health care) be it for democratic reasons (people should have a say in whatever affects them), for reasons of efciency (citizens should be able to point out what they really need, rather than be granted a standard provision), or to enhance the quality...