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A ‘Third Way’ On Health Care That Works From the Netherlands

The Dutch have recently instituted a mandatory private health insurance program that appears to be working well.

by
Leon Eijsman and Leon de Winter

Bio

July 28, 2009 - 12:18 am
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Critics of national health care models warn of British or Canadian situations, and they are correct to be suspicious of truly socialized medicine. Government commissions should not decide upon patients’ treatments. On the other hand, should insurance companies have the right to cut off treatments and end the coverage of high-risk patients, and operate as any other industry in a free society?

Health care may be the number one issue at the moment in America. Those who are left-of-center favor a “single payer” model, in which the federal government creates a new and frighteningly strong power as the keeper of the nation’s health. Those right-of-center want to keep the present system, which demands from the (lower) middle classes excessive chunks of their income.

Is there a third way? Is it possible for a mature and self-conscious society to organize national health care without unnecessarily limiting the freedoms of both the healthy and the sick?

Yes, it exists. The third way is the Dutch way — a functioning and greatly performing model that is regarded at the moment as the best answer to the question of universal health care.

The Netherlands has a population of only 16 million, but it nevertheless has the 16th biggest economy in the world. It is a perfectly organized and diverse society with well-educated citizens who, in the last decade, have been introducing the pressure of competition and the marketplace to their welfare state. They have renovated and redesigned their once “socialized” health care system.

And it works.

In the Dutch health care system, the essential module is the so-called Base Care Insurance (BCI), set by the government (and approved by parliament) and completely executed by private health insurance companies. This BCI — obligatory for every citizen — is financed by taxes and a personal monthly payment to the insurance company of choice (most of them offer extra items in their base package to attract business) of about 90 euros and a yearly deduction of 150 euros. Children under 18 are free.

The BCI covers everything a 21st century patient needs — including limitless visits to his own local GP of choice (who also can visit the patient at home), visits to specialists, surgery, transplants, medication, hospitalization, ambulance costs, ER costs, and the whole extended range of modern health care a wealthy society should be able to offer to its demanding citizens. And there are more options on top of this base level. As an individual citizen you are free to extend the vast care that already exists within the BCI with exotic therapies (like acupuncture), individual rooms in hospitals, a choice of menus, and IVF/ICSI treatments. A complete “luxury package” with dozens of perks for a family of four is being offered by insurance companies for under 400 euros per month, including the base fee.

This health care model costs about 9 percent of the GNP of the Netherlands — more than 6 percent cheaper than the American model. Life expectancy is 79.4 years; in the U.S. it is 78.11. Not only do the Dutch on average live longer, but the quality of life of their elderly easily beats that of Americans because of the easy access to excellent health care.

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