In the Netherlands universal healthcare is not only the standard but also involves a healthy amount of market competition. Kerry Weens, a senior U.S. Department of Health official, recently lead a delegation of Americans examining the Dutch health care system:
"We're intrigued by many of the ideas that we see, such as moving toward more market based solutions. In general I think there's a lot of consistency between the Dutch system and the US system."
John Tyler and Reinout Van Wagtendonk of Radio Netherlands report on the American delegation’s visit.
Mr. Weens was referring to a recent overhaul in the way Dutch people purchase health insurance which have made the Dutch system more competitive. Two years ago, a new law went into effect requiring every resident of the Netherlands to purchase their own health insurance, while the insurance companies were forced to embrace open market laws and offer competitive prices for their insurances. But unlike in the United States, for those who can't afford insurance, the Dutch state still chips in to cover part of the cost.
Insurance companies are required to provide coverage for anyone who applies for it, so no one can be refused due to pre-existing health problems. To help insurance companies cover some of the costs involved with selling coverage to all comers, the government has a formula in which it contributes to the cost incurred in certain cases.
So while competition has been introduced into the system, the Dutch system is not a completely market-based approach. The taxpayer still subsidizes a not insignificant percentage of care in the Netherlands. But competition helps keep overall costs down.
In Health Care Reform Now!, George Halvorson advocates finding a uniquely American path to universal coverage while learning what we can from other nations who already have their own systems of universal coverage. This sort of fact finding mission is exactly the type of research that needs to be done in order to synthesize our own uniquely American solution.
The Dutch approach also share’s Mr. Halvorson’s views on preventative care and transparency.
"We pay a lot more attention to prevention -- we have a coordinated, multidisciplinary approach. In Holland there's quite a lot of proactive action attached to that aspect of health care," said Nolene Berkhout, a nurse practitioner who served as one of the hosts of the American delegation.
A number of recent changes are meant to improve the quality of care here in the Netherlands. Doctors and hospitals are now required to publish information every year about their performance. That information is available to the public on a website, but it is still too soon to see how much effect it has on patients' choices.
SOURCE: "U.S. Officials Impressed by Dutch Healthcare System" 11/12/07
photo courtesy of Pear Biter, used under this Creative Commons license