With all of the recent debate about healthcare in the US, I thought I’d outline the Dutch healthcare system and describe a typical visit to our family physician.
For 2016, the Netherlands tops the list of 35 countries in the Euro Health Consumer Index for the best healthcare services and has consistently been in the top 3 in the rankings since 2005.
According to the report, the Netherlands healthcare system has a #1 ranking, a choice of private health insurance providers acting in competition, good accessibility and participation by patients, and less involvement by politicians and bureaucrats. Sounds good, right? So how does it work in practice?
When I have a health issue, I book an on-line appointment, usually a few days in advance. If it is a pressing matter, I can almost always call in the morning and get an appointment that day. I walk about 7 minutes to my huisarts, the local general practice physician. Huisarts are sprinkled all throughout the Netherlands. The goal is to have everyone within a short distance to their huisarts. Many require patients to live in a certain postal code in order to register there as a patient.
I wait no longer than 10-15 minutes in the reception area for my name to appear on a tv screen indicating that it’s time to proceed to my physician’s office.
My smart-casually dressed physician (no white coats or suit jackets here!) greets me in Dutch, then switches to perfect English upon my request. We proceed to the adjacent examination room where he enters all the information about my complaint into a computer on his desk, located near the examination table. He performs any necessary exams and enters any prescriptions into the system that prints out a prescription form that may be filled at the apotheek, my neighborhood pharmacy, a short 5 minute walk away. There is no cost or co-pay to see any doctor who is affiliated with the huisarts. It is covered in full by my basic insurance plan.
At the pharmacy, I present my prescription and receive my medication. Any charges not covered by insurance will be paid for by my insurance company and billed to me at a later date. Our experience indicates that out of pocket prescription costs are a fraction of the cost for the same medications in the US.
Health insurance is mandatory for all persons in the Netherlands, with very few exceptions. Our monthly insurance premiums are around €100 per person, per month. Our yearly own risk (deductible) is €385 per person, per year. There are no exclusions for pre-existing conditions. Any children under age 18 are covered 100% under a parent’s insurance at no additional cost with no co-pays or deductibles, including full dental coverage.
A 5.65 percent healthcare tax is levied on our self-employment income in addition to our monthly premium, which creeps our total expenditures on mandatory healthcare payments up to about €200 per adult, per month.
A healthcare allowance (zorgtoeslag) of up to around €84 per month is available to all persons holding a valid residence permit earning less than €27,857 per year as a single person or €35,116 as a married person, considerably reducing the health insurance net premium cost on a sliding scale.
This Expatica article contains a comprehensive explanation of all aspects of the Dutch healthcare system from an ex-pat point of view.
Before anyone starts to feel sorry for Dutch huisarts….,”But what about the doctors’ salaries?” one might ask. “They can’t possibly be making a decent living!” The Netherlands also manages to be #1 in salaries for physicians, beating out the US at #3. Considering the average US medical school tuition is twice the cost of Dutch medical school tuition and the average US medical student loan debt is over $189,000, you can bet that the average Dutch huisarts manage to keep a lot more of their salary. Dutch government student loans are available to Dutch citizens at a paltry 0.81 percent interest!
We couldn’t be happier with the quality of the medical care we’ve received, and we can’t believe that the self-employed here have the same access as employees to excellent and affordable health insurance. We’ve changed huisarts with each of our 3 moves, and we’ve found all of them to be very compassionate, professional and knowledgable–and their English impeccable.
As a American friend who also lives in the Netherlands said to me recently, “The US acts like no one in the world has this health care thing already figured out.”
The answer to good, affordable healthcare in the United States exists. One only needs to look to the Netherlands for guidance.