The view from Holland: Your system is broken

I follow the Danville Register & Bee on Twitter from my home in The Netherlands and I regularly read what’s going on in and around Danville from across the ocean.

I was most surprised by one opinion expressed by a letter to the editor in the past few weeks. The writer stated that many Canadians and Europeans are actually traveling to America to receive medical care because of the long waiting lists in their home countries.

This could be true, but only — and only should be stressed — for the very rich. I would say that the vast majority of Dutch — and for that matter, other Europeans — would not want to exchange health care systems.

In fact, most Europeans regard the American health care system as the laughingstock of the Western world.

About 10 years ago, I had an acute appendicitis. There was a minor complication and I ended up not spending the usual two or three days in hospital but 10. I was in a comfortable room that I shared with one other patient, I had a television (I would not be surprised if these days even more entertainment is available), I was very well taken care of and after 10 days I was well enough to go home again. The main point: I never saw a bill.

Two years ago, my mother was diagnosed with breast cancer. When a suspicious “spot” was found on an X-ray, a biopsy was made within 15 minutes. It took a week to get the results from that, which showed definitively that it was cancer. Six days after that diagnosis, my mother was operated on. The operation got rid of the tumor, and it had not spread. My mother underwent the latest form of chemotherapy for six months after that. One type of medicine she received 13 times during those six months cost 1,500 euros (about $2,100 at today’s exchange rates) every time. Thanks to the semi-socialized (or semi-private) health insurance system in The Netherlands, it only cost my family 200 euros ($285) per month extra those six months. All the research and the operations were free.

This means that in total, getting cured from cancer cost my mother only 1,200 euros ($1,700).

Because today I make less than 25,000 euros ($35,600) per year, the Dutch tax services (the government) actually gives me 58 euros ($82) per month to help pay for the insurance fee I pay the insurance company. This means that someone like me only pays 42 euros ($60) per month for health insurance (Or less, because I have the extra dental insurance of about 10 ($14) euros per month extra).

It is mandatory to have health insurance in this country. Even if you’re homeless, you would be required to have health insurance.

Whenever I come over to visit the United States, I take out an additional travel insurance of about 15 euros ($21) for 10 days, which would also cover any health care issues. I would not feel comfortable in the United States without it.

My family has the base fee (a monthly premium) of about 100 euros ($142) per month, which is pretty average for an insurance company here. Health insurance companies in this country are not allowed — by law — to refuse anyone on the basis of pre-existing conditions, for example. We are free to choose our own doctor and hospital (where this socialized health care myth comes from is beyond me). I have to admit immediately that the government abandoned the purely “socialized” health care system about five or 10 years ago, it’s now a typical “public-private partnership.” The insurance companies are strictly regulated, though.

In France, you can choose your own doctor and hospital, too. The system in the United Kingdom does assign you a doctor — the general practitioner that is closest to where you live — but it is possible to change if you are not happy with your doctor, and since 2008, you can also choose your hospital in the UK.

The fact that a “Remote Area Medical” team has been operating in the United States to provide free medical care to the uninsured — rather than somewhere in the remote Amazon — is a telling sign, I believe. I was shocked by last year’s 60 Minutes story about that group. Then there was the story in the Danville Register & Bee, “Nearly 2,000 show up for free health care,” (July 25, page A4).

I have a close friend who is a doctor here, and she says she would not like to work in the American system for the simple reason that it would be unethical in her view to have to deny a patient the best possible care for the simple reason that he or she couldn’t afford it. Although it’s possible doctors in America are paid more, my friend earns a very respectable and impressive salary, and working in the American system would be a price she would not be willing to pay for a bigger paycheck.

In short, from a European point of view, the American health care system as it is a disaster. Again, what surprises me most is the fact that so many Americans seem to think the system is fine — and that even the rest of the world envies it. No Western country in its right mind would want to adopt the current American system. The Dutch system isn’t perfect either, nor is the British, French, or the Canadian systems. There will always be corruption and people will always fall though the cracks. But to me, the American health care system seems inefficient, and especially terribly, terribly, terribly unfair.

• Abbink, 27, lives in Groningen, Holland, and works part-time as an English teacher at the University of Groningen while finishing up his master’s degree.