Health

Competition and cooperation can also work well in healthcare

July 2, 2015

In this column, Jo Caris wonders why care providers are not allowed to work together. There are plenty of wonderful examples of cooperation and competition. 

Image: © Nationale Beeldbank

Higher quality care and, in particular, greater efficiency in healthcare must be achieved through competition. That is the government policy whose implementation is monitored by the Netherlands Competition Authority (NMA). The NMA does not allow cooperation. However, cooperation between care providers is sometimes necessary. The same cooperation can lead to greater efficiency and better quality. Who could object to providers referring patients to other organizations because he or she would be better off there or because that other care provider still has available capacity. Working together also helps when there is strong demand for high-quality care where knowledge, skill, and volume must be shared.

But that is not allowed by the competition policy. It is either cooperation or competition.

Wonderful examples

That is remarkable. All around us we see wonderful examples of effective combinations of cooperation and competition, such as in sports. Football clubs compete for profits, the competition is obvious, and we very much enjoy it. Yet, members of the Dutch Football Association work together hard – just think of the rules of the game. There is competition between countries, but there is cooperation within a larger context, such as within the UEFA.

Even on a smaller scale you can find that particular combination of cooperation and competition. Cooperation is very important within teams. After all, it is the team that wins. But the team performance is also determined by the individual performance of team members. There is thus also competition within a sports team, which is supposed to stimulate individual performance. One player will work harder because another player is eager to take his place.

Rivalry and collaboration 

It is up to the trainer to achieve the right balance between healthy rivalry and the necessary cooperation and then maintain that balance. The spectators will not care whether prices are agreed for tickets, parking, and drinks at half time. As long the competition on the field produces an attractive game.

Healthcare is, of course, not a sport and this comparison will therefore fall short. But why would the combination of cooperation and competition not be possible in healthcare?

Let caregivers work with concerted prices, let them agree ground rules, and let them compete mainly to deliver the best possible care. Such mutual competition can also be very interesting for professionals involved.  Who performs the best operations, has the least complications, where are the least bedsores, whose customers are satisfied the most? What could be better than to continue striving for an even better performance in your field? And what is wrong with making that performance clear to citizens?

We should not let newspapers or others make this performance public. Instead, healthcare providers should organize their own competition and share their performance indicators. And let them do that in good cooperation with good agreements that make the competition fair and, consequently, optimal.

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