Dutch Health Care? I’ll Take Albuquerque

Advocates of government-provided health care point to European systems as models. “Socialized medicine is good, and you get it free,” they say.  Well I have friends and relatives in Europe, mostly in the Netherlands, and I’ve spent considerable time dealing with the Dutch medical system on behalf of my mother.  I’ve learned that it’s not all that good and most certainly is not free.

Dutch medical care appears to be adequate, though there’s often a long wait for a specialist.   In particular, medical care for the elderly is tightly rationed.  If you’re past a certain age, no more pap smears (which detect cancer), mammograms, hip replacements, or other treatments deemed “not cost effective.” In other words, someone in authority thinks you’re not worth it.  So live in pain, or pay for treatment yourself.

I am no expert in health care, so I can’t compare Dutch doctors to Americans in technical terms.  But I will say that our doctors here in America are more personally interested in their patients and spend more time with them.  In contrast, Dutch doctors tend to be less personal. You are assigned to a doctor, and if you don’t like him it’s very hard to switch.  Moreover, you’re assigned to one in your neighborhood, with the result that people in richer neighborhoods get the best doctors.  So much for the equality that socialized medicine is supposed to bring.  Anyway, considering the quality of the care, I much prefer our Albuquerque doctors, nurses, and hospitals.

This may all change if the White House has its way on health care reform.  I doubt that our doctors will be so charming when their Medicare reimbursements are reduced, patient loads go up, and regulations multiply.

What about the price the Dutch have to pay? In Holland, everyone is covered by a government-run health insurance, but they have to pay for it.  For example, a retired couple pays around $400 a month, deducted from their pension.  Working people pay more. Some dental procedures require a large copayment.  But these fees fall far short of the huge costs of socialized medicine, and so much of the funding comes from Holland’s heavy taxes.  Their income tax can reach a maximum marginal rate of 60 percent.  Most goods are subject to a value added tax of 19 percent.  Cars and gasoline are heavily taxed, and a flock of other taxes also are collected.  So it’s either premiums, taxes, or some of both.

Socialized medicine costs plenty.  And it’s not “the government” that pays; it’s everyone. Those who think that socialized medicine will relieve them of the costs of insurance are deluded.

Agnes Brown is an Albuquerque resident and American citizen. She was born in Amsterdam, Holland, cared for her mother’s end-of-life needs under the Dutch health care system, and maintains many contacts in the Netherlands.