The state of Dutch healthcare

In the land of plenty and high taxes (or should that read “plenty of high taxes”?) a development has been underway for sometime. The development is “Tax by Stealth”. This development pulls on the heart-strings of what most Dutch people either like to believe or pretend to be the case, and that is “to be seen to be doing the right thing” and is based on the fundamental foundations of what most Dutch people call “the Polder model”, which is nothing more than a euphemism for what we in Ireland would call “the Welfare State”. In other words, those with money and means should pay for those without.

Don’t get me wrong, I’m not saying that one should not pay taxes or that my taxes should not be used to either ease the burden of my less unfortunate neighbour who has fallen on bad times. On the contrary. But the discussion about high taxes is for another time. This rant is about being FORCED to pay for private health insurance, which in previous years was paid for via my taxes, and not getting a decent level of service in return. The real route cause for the failure of this grand plan is centred around that one single thing that most Dutch either have no concept of, or are unable to provide….SERVICE.

The expat community here will usually regale you of stories where they visited their GP (huisarts here in Holland) when they were suffering from flu or some other every day ailment, only to be told “Stay at home for a few days and take some paracetamol”. Fine and dandy if you are trying to avoid the population from taking too many antibiotics and thus lowering the nations immune system from its over dependence of prescription meds. However, when someone is ACTUALLY sick, once would expect a different tack from ones physicians. Not so in the land of tulips. Nope, no matter what the ailment, the usual treatment is “stay at home and take a paracetamol”. As you can see already, our insurance is great value for money!

A recent personal experience has left me wondering why on Earth am I paying so much for healthcare, when at the point of needing said healthcare, I would probably have been better-off to go abroad to some Eastern European hospital (read the Dutch cynical belief that Eastern Europe is the “3rd world” on such matters) for far better, and concise, diagnoses and treatment. Not to bore you with my ailments and diseases, but let me very briefly explain to you my experiences.

I suffered from a very common skin disorder when I was in my teens, which was combatted through the use of medicated shampoo and cold-tar soap. The condition was kept at bay, and all but disappeared as I got older, with odd exception of re-manifesting itself if I am a little run-down or under a lot of stress. As it happened, I was under stress at work at the time and my skin problem came back. Not to worry, I live in the Netherlands, a modern, wealthy developed Western nation. I’ll ring up my doc and have him prescribe me something. Yes-but-no-but….the GP could not prescribe me with the necessary stuff I would have gotten from my GP in Ireland, for this I had to visit a Dermatologist. OK, refer me to one then. Certainly……I can get you an appointment in 2 months….TWO MONTHS!!! Fear not…..for I have private health insurance!! I’ll just ring up the health insurance company and ask them to get me an earlier appointment. “Yes Sir, that we can do…the next available appointment will be in six weeks….SIX WEEKS, not much of an improvement, is it? As luck would have it, I was visiting Herself in Finland that same week. I flew up on the Friday, griped about it to herself who suggested I call the polyclinic down the road and see if they can do anything. Amazingly, the Finns were able to get me an appointment for later that same day AND the Dutch health insurance confirmed that I would be 100% compensated.

Fast-forward to a few years later, were Myself and Herself have been trying for children now for quite sometime. We went to our GP, who referred us to the local hospital to see some specialists. So far, so good. Herself had all manner of things done to her and a blood test, all confirming that there was nothing wrong with her plumbing. “Hmmm”, says I, “must be my swimmers then”. I was asked to provide a sample. Which is when the first problem started. In any other hospital in the developed world, one might expect a specific room in the Urology department where one can whip-up a sample and provide it immediately to the folks in the lab who would then start their count and whatever else they do. Not so in Holland. No, our hospital only allows samples to be handed in by the patient between the hours of 8am and 9:30am…..and there’s no special room to use on the premises. One needs to do that job at home first thing in the morning. And then, as was the case with me, rush to the hospital super fast in -3 degree weather to give the sample before their lab closes…..VERY convenient. Hurdle one passed, I then get a call confirming that the swimmers are indeed a little on the slow side. But not to worry because “we’d like you to see an Urologist to take a closer look”. Alrighty then….a few weeks later, I show up at the Urology Department at the same hospital. I’m met by the doctor, who takes me into his hospital and proceeds to ask me the following questions:

  1. How old are you? Answer….early 30′s
  2. Do you smoke? Answer….No
  3. Do you have any pain when “pissing” (his exact words)? Answer….No
  4. Do you “piss” standing up or sitting down? Answer….Standing up of course!
  5. Do you have a stressful job? Answer….Not especially, just the odd deadline from time to time

Questions over and done with, he then he asked me to go to the examination room next door and drop trou’. He stood about 2 metre’s away from me, looked, hemmed and hawed and then said “you can get dressed again”. What….No poking, no prodding, no “Cough please”??? No, apparently that’s unnecessary. His diagnoses? “You should try pissing sitting down for a month” WTF!!!! I was flabbergasted….firstly, no proper examination, no probing questions about diet, drinking habits, how often do you do it, boxers or briefs, exercise regularly, nothing, nada, ZIP!! No, in his professional opinion, I should be pissing like a girl!! I was not only shocked, but I was outraged that my insurance money is being spent on this quack who didn’t even examine me properly and gives me the kind of “old wives” recommendation that most Expats have come to expect from the Dutch medical establishment.

If I had gone to see a doctor either in Finland, or Ukraine, or in my native Ireland, I would have been subjected to a lot of poking and prodding not to mention the battery of tests and bloodwork they’ve have done. The other amazing thing about the healthcare system is that the establishment KNOWS how bad it is, yet feigns interest in doing anything about it. Except of course if you’re a Dutch Turk. Dutch Turks have known far longer than I about how bad the system is here ….probably because I’ve only had to go to the doctor until very recently. They have left in their droves to get everything done from tooth fillings, wisdom teeth extraction, all the way up to corrective cardiac surgery, laser eye treatment and anything else you can think of. The amount of money that the insurance companies pay out to Dutch Turks for healthcare undertaken in Turkey is so much that they’ve now set-up a Turkish run hospital in Amsterdam in order to stem the outflow of cash leaving Dutch shores.

What I can’t understand is why the average Henk or Ingrid is happy to accept below average healthcare….especially when he is being forced to pay through the nose for his insurance. Suffice to say, we’ve opted to go and visit a real doctor abroad.

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