Read this interview with Dr. Roland Bal, of Erasmus University & MC, titled "New Healthcare System, New Problems."
Here's the intro:
"Exactly two years ago the Dutch healthcare system underwent drastic changes aimed at limiting the costs of healthcare and increasing freedom of choice. What have been the results so far? It is starting to look as if premiums continue to rise, while insurance packages are shrinking. Moreover, health insurance companies are increasingly deciding where and by whom their customers are treated by setting up insurer-financed healthcare centres."
It seems there is worldwide concern for our uninsured (and corresponding international interest in the policies/procedures we enact to address the issue).
When asked if Holland is heading for a situation like the one in the US, Bal replies:
"But then on a much smaller scale. There are 47 million people uninsured in the US. That is a much more serious problem. But you do see that the numbers have been growing over the past years here as well.”
The Netherlands struggles with the same issues as US providers, including continuous improvement of the care environment.
What do you think has to change in the current system?
“In any event much more attention must be focused on the quality of care. The ministry now feels that the sector should take care of that itself. The government sets all sorts of requirements on the field and then sends outs the inspectorate. But if the government feels it is so important, it should also invest a great deal in it. One of the major risks of liberalisation is that more and more focus comes to lie on costs. Of course it is possible to reduce costs, but that comes at a price, namely that you sacrifice quality. The one-sided incentive focused on costs at the moment, also doesn’t motivate the people who work in healthcare. And, ultimately, I also think that quality simply comes at a price.”
The most valuable part of the interview? The closing reminder that somehow, somewhere, someone has to pay for all this healthcare and quality improvement.
And guess what? Holland is focusing on how to make sure that payer is the consumer. It IS our health - do you agree the burden of payment for care should be ours?
And the consumer pays?
“Yes, in the end the consumer will have to foot the bill in one way or other. Either via tax, or via insurance.”
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2 comments:
It goes to show you that paying for healthcare is like a balancing act. People who believe that choice and freedom are the only concern are missing that the health of the community as a whole is affected. On the other hand when one tries to take care of everyone, choice must be restricted. Or does it?
I will most likely be one of the victims of this new system, suffering from a doctor who shouldn't have performed a certain treatment on me. Yet the insurance company has a right to deny me any further coverage in treatment that would return the quality of life even 50%.
In the article from Bal: What are the consequences for all those uninsured individuals? “They are only really treated for life-threatening conditions, serious accidents and that sort of thing. Some hospitals are very strict about his, since they have to foot the bill otherwise. And that can result in serious public health problems.”
Not just this, but they are fined by the government as well for not having insurance. They claim that they don't know why people aren't getting insurance, but the truth is that you're taxed (at least) 40% on your salary and then throw in all the other taxes; city, sales, environmental, you name it, they've got an extra tax for it. Many people are going under financially here because of the high taxes and health insurance is becoming a luxury that they just can't afford. Even with that great "subsidy" for many it's still unaffordable. And where do people think this subsidy comes from? It comes from taxes, so in essence, even if I was eligible for a subsidy I'm in fact contributing to that as well.
He is right that the quality of care needs to be better here. But the Dutch mindset has a lot to do with lack of care here. Work mentality often has a communistic feel to it, that people show up, do their time, and then head home. In my experience (as an American living here for eight years and being fluent in the language) they've taken the "care" out of health care.
The only winner in this scenario are the insurance companies. Surprise, surprise.
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