Demand-driven care is oriented towards an empowerment of patients/consumers through a redistribution of responsibilities and control among government, healthcare providers, insurers and patients. Different normative approaches can be distinguished in the discussion about the implementation and development of demand-driven care. The economic approach is aimed at competition and consumerism. The democratic approach of demand-driven care focuses on shared social responsibilities and accountability between the actors involved. In practice both approaches don’t get full meaning. The characteristics of sub-sectors within the healthcare system, institutional inertia and conflicting interests hamper a real shift form supply-oriented towards demand-oriented health care.Session 4: Public Managemen