Health care in the Netherlands

I just read an interesting article in the September issue of The Progressive magazine on a subject I’ve been curious about, namely, health insurance in the Netherlands. It’s interesting because the Dutch system is based on private health insurance and an individual mandate, very close to the part of the U.S. Affordable Care Act (“Obamacare”) that takes affect in 2014 for people not covered by Medicare and Medicaid.

The writer, Nina Siegal, is an American journalist who has lived in the Netherlands since 2006, so she has direct experience with both countries’ health care systems, and she’s clearly more enthusiastic about the Dutch one than the American one pre-ACA.

Under their system, the government requires virtually all individuals and families to be insured either through employment or through buying coverage out of pocket, and it subsidizes policies for those with low incomes. Consumers can choose bare-bones coverage or gold-plated coverage (which covers even cosmetic surgery) or something in the middle. Siegal says that the bare-bones policy would have cost her about $110 per month and the one she bought — which includes full prescription drug coverage with no copays, some dental, and even eyeglasses up to about $200 per pair — runs her about $200.

When she first called to make an appointment with a nearby doctor the receptionist told her there was no way they could see her right away — she’d have to wait until the following afternoon.

She acknowledges that the system isn’t perfect, but one of her complaints is that doctors don’t prescribe antibiotics as eagerly as American ones do. Given the way overprescribing has created lots of scary drug-resistant pathogens in the U.S., the Dutch policy sounds more like a feature than a bug.

The Dutch system is very family-friendly. When she gave birth, Siegal says, she was, like all Dutch new mothers, assigned a home health care nurse called a kraamzorg, which I gather really is Dutch and not Klingon. For the first 10 days after birth, the kraamzorg visits for six hours every day, ensuring that the mother and newborn are in good health and that the new mother is up to speed on baby care. In addition, the kraamzorg gives Mom some needed rest by fixing lunch and doing some housecleaning. Though Siegal says this is unique to the Netherlands, I’m pretty sure that France (and I think some other European countries as well) offer something similar.

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