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Going Dutch
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| Parent(s) |
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| Contributor | RP |
| Last Edited | RP May 07, 2009 07:02pm |
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| Category | Commentary |
| Media | Newspaper - New York Times |
| News Date | Thursday, April 30, 2009 12:00:00 AM UTC0:0 |
| Description | The Dutch health care system was drastically revamped in 2006, and its new incarnation has come in for a lot of international scrutiny. “The previous system was actually introduced in 1944 by the Germans, while they were paying our country a visit,” said Hans Hoogervorst, the former minister of public health who developed and implemented the new system three years ago. The old system involved a vast patchwork of insurers and depended on heavy government regulation to keep costs down. Hoogervorst — a conservative economist and devout believer in the powers of the free market — wanted to streamline and privatize the system, to offer consumers their choice of insurers and plans but also to ensure that certain conditions were maintained via regulation and oversight. It is illegal in the current system for an insurance company to refuse to accept a client, or to charge more for a client based on age or health. Where in the United States insurance companies try to wriggle out of covering chronically ill patients, in the Dutch system the government oversees a fund from which insurers that take on more high-cost clients can be compensated. It seems to work. A study by the Commonwealth Fund found that 54 percent of chronically ill patients in the United States avoided some form of medical attention in 2008 because of costs, while only 7 percent of chronically ill people in the Netherlands did so for financial reasons.
The Dutch are free-marketers, but they also have a keen sense of fairness. As Hoogervorst noted, “The average Dutch person finds it completely unacceptable that people with more money would get better health care.” The solution to balancing these opposing tendencies was to have one guaranteed base level of coverage in the new health scheme, to which people can add supplemental coverage that they pay extra for. Each insurance company offers its own packages of supplements.
I find that the outrageously significant difference between the two systems is the cost. In the United States, for a family of four, I paid about $1,400 a month for a policy that didn’t include dental care and was so filled with co-pays, deductibles and exceptions that I routinely found myself replaying in my mind the Monty Python skit in which the man complains about his insurance claim and the agent says, “In your policy it states quite clearly that no claim you make will be paid.” A similar Dutch policy, by contrast, cost 300 euros a month (about $390), with no co-pays, and included dental coverage; about 90 percent of the cost of my daughter’s braces was covered. |
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