Jonathan Cohn’s article on superior access to timely health care in the Netherlands and France seems about right to me. Both of our kids were born here in Amsterdam, and the ease and comprehensiveness of the system was remarkable. You get a choice of a few ob/gyns at local health clinics based on neighborhood. You then have a choice of giving birth at home or in a hospital. If you give birth at home, a midwife and an ob/gyn will be put on call to come to your house for the birth. There’s a nationally standardized packet of stuff you have to buy for about 30 euros at the drug store so that the midwife or ob/gyn knows the right materials will be available when they show up at the house. Our daughter Sasha was born in a hospital; our son Sol, in the apartment where we stayed for the summer. Sasha was 2 weeks late, so my wife got a private room in the hospital for 2 days while they induced delivery. After Sol’s birth there were some complications, so EMTs and the fire department showed up to evacuate her through the second-story window to the hospital. (Dutch stairs are too steep to carry a stretcher down.) In both cases, we felt like we were knit into a smoothly functioning national system of health care that wouldn’t let you fall through the cracks. Standard insurance covered everything, and we also got the standard post-natal followup: an experienced helper comes to your house daily for a week to help clean up, give you tips on handling the baby, do your laundry, or whatever you need; a doctor comes for at least one post-natal visit; and you’re then assigned to a local clinic for post-natal followup checkups at several weeks and months.
I’ve never had a serious illness in Holland, but for a couple of bouts of stomach illness, I’ve always just shown up during morning free-access time at my local GP’s office, without an appointment. I’ve never waited more than an hour. It cost I believe 60 guilders at the time — 30 dollars or so. (I’m sure it’s more now.) On another issue that’s more important to me than to most since I’ve lived in the tropics for the past 9 years, it’s easy and cheap to get vaccinated for anything in Amsterdam. You go to the GGGD, the city health care department, and take a number. You get your yellow fever, Japanese encephalitis, or what-have-you vaccinations within an hour or so. In NYC I had to see a doctor specialized in tropical medicine to get the vaccinations; the doctor’s visit cost a couple hundred bucks on its own, and each of the shots was more expensive.
As I said, I’ve never had a serious illness here. But my wife’s parents are getting medical care that doesn’t seem notably different from what my parents have received in the US. In general I think the main difference between health care in the Netherlands and in the US is that in the Netherlands, it’s easier to figure out what you have to do; insurance is universal; and it’s vastly cheaper. I’m sure there are cases of advanced medicine that you can get in the US and that are harder to find in Holland, but I’d bet dollars to doughnuts that has more to do with the larger size and wealth of the US health care market. And, as in the US, if you’re rich enough in Holland, you can buy whatever health care you want.
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