The emergence of the Islamic trust

The Islamic trust, governed by both the laws of the jurisdictionunder which it is written and by Shari'ah law, has become apopular financial and devolution planning vehicle for assetsheld by Muslims. This article examines how these trusts havedeveloped.     

Inleiding Humanitair Oorlogsrecht [Introduction to the Humanitarian Law of War]

Netherlands International Law Review -     

Preferred providers and the credible commitment problem in health insurance: first experiences with the implementation of managed competition in the Dutch health care system

We investigate the impact of the transition towards managed competition in the Dutch health care system on health insurers' contracting behaviour. Specifically, we examine whether insurers have been able to take up their role as prudent buyers of care and examine consumers' attitudes towards insurers' new role. Health insurers' contracting behaviour is investigated by an extensive analysis of available information on purchasing practices by health insurers and by interviews with directors of health care purchasing of the four major health insurers, accounting for 90% of the market. Consumer attitudes towards insurers' new role are investigated by surveys among a representative sample of enrollees over the period 2005-2009. During the first four years of the reform, health insurers were very reluctant to engage in selective contracting and preferred to use 'soft' positive incentives to encourage preferred provider choice rather than engaging in restrictive managed care activities. Consumer attitudes towards channelling vary considerably by type of provider but generally became more negative in the first two years after the reform. Insurers' reluctance to use selective contracting can be at least partly explained by the presence of a credible-commitment problem. Consumers do not trust that insurers with restrictive networks are committed to provide good quality care. The credible-commitment problem seems to be particularly relevant to the Netherlands, since Dutch enrollees are not used to restrictions on provider choice. Since consumers are quite sensitive to differences in provider quality, more reliable information about provider quality is required to reduce the credible-commitment problem.     

Public Research Projects in Europe and East Asia: Cooperation or Competition? A Comparative Analysis of the ITER and Galileo Experiences

The projects discussed in this paper, Galileo and ITER, are two contrasting experiences of Euro-Asian cooperation within Very Large (Public) Scientific Enterprises. They offer key insights into the deepening relations which have given shape to the rapidly expanding field of Euro-Asian collaborative interregional projects. Cooperative agendas within such "Big Science" endeavors heighten the question of the political considerations supporting the decision to engage specific forms of international cooperation. As the main driving force behind both projects, the EU's choices have resulted in the establishment of novel and distinct forms of Euro-Asian scientific cooperation. A better understanding of how such Euro-Asian initiatives emerge can logically be garnered by confronting the Euro-Chinese cooperation within Galileo, and the Euro-Japanese partnership within ITER. This comparison will show that the agendas and institutions of these two interregional policies vary greatly. Within the same policy field - in casu Large Scientific Projects - and in relationship to the same region - i.e. East Asia - this study shows that fundamentally different policies are practiced side-by-side. If in both cases Euro-Asian scientific cooperation has provided its participants with renewed leverage and unprecedented opportunities, the exact scope and function of these interregional collaborations range from the merely tactical in the Euro-Chinese Galileo experience, to the substantial in the Euro-Japanese ITER experience.     

Mapping the consumption of government communication: a qualitative study in Germany

Successful communication between citizens and government is critical for the effective implementation of governance. Although government communication is highly relevant to society, few governments fully exploit the potential benefits of the direct communication instruments at their disposal. To establish foundations for encouraging various forms of government communication, this article starts by examining its reception among German focus groups and thus offering general implications for successful, citizen‐sensitive government communication. The results suggest the need for better articulation of interests in government communication, such that they appear more egalitarian, closer to the citizen, and online—that is, successful government communication demands considerable proximity to citizens, interactive feedback channels, and systematic participation by citizens in political processes. Copyright © 2013 John Wiley & Sons, Ltd.     

Market-oriented health care reforms and policy learning in the Netherlands

In this article we analyze the evolution of market-oriented health care reforms in the Netherlands. We argue that these reforms can be characterized as policy learning within and between competing policy programs. Policy learning denotes the process by which policy makers and stakeholders deliberately adjust the goals, rules, and techniques of a given policy in response to past experiences and new information. We discern three distinctive periods. During the first period (1988-1994), the prevailing corporatist and etatist policy programs were seriously challenged by the proponents of a new market-oriented program. But when it came to political decision making and implementation, the market-oriented program soon lost its impetus because it was technically too complex and could not provide short-term solutions to meet the urgent need for cost containment. During the second period (1994-2000), the etatist program regained its previously dominant position. In parallel to a strengthening of supply and price controls, however, the government also persevered in creating the technical and institutional preconditions for regulated competition. Moreover, public discontent over waiting lists and the call for more autonomy by individual providers and insurers strengthened the alliance in favor of regulated competition. This led to the revival of the market-oriented program in a 2001 reform plan. We conclude that the odds of these new post-2001 reforms succeeding are substantially higher than in the first period due to the technical and institutional adjustments that have taken place in the past decade.     

Subacute fatal aluminum poisoning in dialyzed patients: post-mortem toxicological findings

The population of Cura?ao, Netherlands Antilles (133,000) shows a very high prevalence of end-stage renal disease (approximately 1 per 1,000). These patients are often treated chronically with haemodialysis. As the drinking water on the island is prepared by distillation of sea water, the haemodialysis fluid used to be prepared with tap water without further treatment. In 1996, the 27 patients of one of the dialysis centers on the island presented with nausea, vomiting, and hypercalcaemia in a short time span, which was initially diagnosed as 'hard water syndrome'. In spite of treatment with low-calcium dialysate, microcytic anaemia and neurological symptoms developed. Ten patients died of convulsions, sepsis, and coma. As aluminum (Al) intoxication was suspected, Al in serum (AlS) was measured. Ante mortem AlS was 808 microg/l (n = 7; range 359-1189); in the survivors AlS was 255 microg/l (n = 17; range 113-490). Normal AlS is < 10 microg/l, and <50 microg/l in asymptomatic dialyzed patients. The court requested post-mortem toxicological analysis of four patients. Al concentrations in liver, bone, and cerebral cortex were significantly increased as compared with background levels. Al intoxication was, therefore, considered to be the most likely cause of death in these patients. Investigations of the tap water supply revealed that a few weeks before the onset of the symptoms, a water conduit pipe to the dialysis unit had been replaced, which was lined with Al- and Ca-rich cement mortar. These ions leached into the distilled water and caused both Ca- and Al-intoxication through uptake from the dialysate into the patients' circulation. The symptoms of the latter were initially not recognized as they were masked by the symptoms of hypercalcaemia.     

Effects of purchaser competition in the Dutch health system: is the glass half full or half empty?

In 2006, the Dutch health insurance system was radically reformed to strengthen competition among health insurers as purchasers of health services. This article considers whether purchaser competition has improved efficiency in health-care provision. Although supply and price regulation still dominates the allocation of health services, purchaser competition has already significantly affected the provision of hospital care, pharmaceuticals and primary care, as well as efforts to gather and disseminate information about quality of care. From this perspective, the glass is half full. However, based on the crude performance indicators available, the reforms have not yet demonstrated significant effects on the performance of the Dutch health system. From this perspective the glass is half empty. The article concludes that the effectiveness of purchaser competition depends crucially on the success of ongoing efforts to improve performance indicators, product classification and the risk equalisation scheme.