Netherlands Healthcare
May 20, 2009
– Comments (13)
Netherlands healthcare switched from a fully public version to a public/private version in 2006. costs.
My understanding is that less than 2% of people were dissatisfied with quality in 2006, the switch was an effort to control costs.
Their system is mandatory purchase of insurance from private companies, subsidized by a portion of a 6.5% income tax. Average per capita salary is 23k, as compared to the US at 33k.
The Gov't decides on a minimum coverage, at a cost of $1600/year. There is also a $250 deductible which many insurers wave if you go "in-network".
The public/private insurer model is very young in the Netherlands. It remains to be seen if the insurers will pressure Doctors/hospitals etc to the point of lowering quality to save costs as they have here. There is already pressure to reduce hospital stay lengths.
Notable cultural differences:
Most GP's in the Netherlands are reluctant to prescribe drugs, and usually prescribe the lowest dosage for the shortest possible time.
Most births are natural and at home, under professional care. About 10% go to a hospital.
Assisted suicide is a socially acceptable end of life choice.
Link from the Burril Report
An American expatriate, Russell Shorto, writes about living in Amsterdam for the NY Times, the shock of income tax, and the relief of many other missng taxes, and the quality of healthcare in "Going Dutch". It is a good read for many reasons, besides healthcare.
Nobody thinks the Dutch health care system is perfect. Many people complain that the new insurance costs more than the old. “That’s true, but that’s because the old system just didn’t charge enough, so society ended up paying for it in other ways,” said Anais Rubingh, who works as a general practitioner in Amsterdam. The complaint I hear from some expat Americans is that while the Dutch system covers everyone, and does a good job with broken bones and ruptured appendixes, it falls behind American care when it comes to conditions that involve complicated procedures. Hoogervorst acknowledged this — to a point. “There is no doubt the U.S. has the best medical care in the world — for those who can pay the top prices,” he said. “I’m sure the top 5 percent of hospitals there are better than the top 5 percent here. But with that exception, I would say overall quality is the same in the two countries.”
Indeed, my nonscientific analysis — culled from my own experience and that of other expats whom I’ve badgered — translates into a clear endorsement. My friend Colin Campbell, an American writer, has been in the Netherlands for four years with his wife and their two children. “Over the course of four years, four human beings end up going to a lot of different doctors,” he said. “The amazing thing is that virtually every experience has been more pleasant than in the U.S. There you have the bureaucracy, the endless forms, the fear of malpractice suits. Here you just go in and see your doctor. It shows that it doesn’t have to be complicated. I wish every single U.S. congressman could come to Amsterdam and live here for a while and see what happens medically.”
Healthcare expenditure per capita in 2007 in US$:
$3092 Netherlands
$6096 United States
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