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This article describes the results of an empirical study into the design and effectiveness of the co-pay in Dutch Health care. With a reconstruction of the policy theory and the application of "the instrument theory" of Bressers and Klok, we are able to predict that the co-pay would not be effective. A process evaluation and an effect evaluation show that this is indeed the case. Not surprisingly, the second Kok administration determined that the instrument would be terminated.  相似文献   
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