Guest lecture risk equalization

risk equalization

Economics of the Dutch health care system
Minor Health Care Management
VU University Amsterdam


Piet Stam, PhD

Equalis Strategy & Modeling

VU University Amsterdam


September 13, 2022


The slides of the lecture are not included here, they are on the blackboard of your university.

Flow chart

In this talk, we ended the section on the goal of risk equalization with a flow diagram connecting competition -> regulation -> incentives -> behavior -> effects. You can watch an interactive version of this flow chart in 6 slides in English or in Dutch.

After a first watch, try to tell the story behind these slides in your own words. It is a good test and will help you to spot the parts that you might not fully understand yet. You may then read your slides to help you fill in the blanks.

Risk equalization app

You can find the risk equalization app here. Just play around to get the hang of it.

Food for thought

The goal of risk equalization was explicitly described in detail in the Dutch Health Insurance Act (2006) about here. It is interesting to read and may slightly differ from how it was described in my talk.

Surprisingly, despite a long history of developing a very sophisticated risk equalization model, currently there is much discussion about the goal of risk equalization in the Netherlands. I co-authored an article with a summary of this debate in which we also propose a way out of this controversy.1

  • 1 See Ven et al. (2022)

  • Furthermore, note that some people have high expectations about solving economic problems in health insurance and health care by risk equalization. To put these expectations into context, I authored an article (in Dutch) claiming that risk equalization is not a panacea.2

  • 2 See Stam, Visser, and Goudriaan (2015), download the public version from my Zotero page here

  • All in all, given these debates, it is important to get a better understanding of risk equalization in order to be able to judge what’s right and what’s wrong.

    Last remarks

    These were the first few references that are nice to read/view. They already give you much to think about. Just send me a DM on Twitter if you want to know more.


    Stam, P. J. A., J. S. Visser, and R. Goudriaan. 2015. “Risicoverevening Is Geen Panacee.” Economisch Statistische Berichten 100 (4720): 624–27.
    Ven, Wynand van de, Gerrit Hamstra, Richard van Kleef, Mieke Reuser, and Piet Stam. 2022. “The Goal of Risk Equalization in Regulated Competitive Health Insurance Markets.” The European Journal of Health Economics, March.


    BibTeX citation:
    @online{stam, phd2022,
      author = {Stam, PhD, Piet},
      title = {Guest Lecture Risk Equalization},
      date = {2022-09-13},
      url = {},
      langid = {en}
    For attribution, please cite this work as:
    Stam, PhD, Piet. 2022. “Guest Lecture Risk Equalization.” September 13, 2022.