The Dutch Healthcare System

If you ask a Dutch person, they would say to not expect too much from the medical system here.  It's known for not taking concerns very seriously and suggesting paracetamol for just about everything.  They'll say it's too bureaucratic, that it takes too long to navigate the procedural steps, and that there's not enough choice.

But.

In my opinion, the Dutch (just like everyone else) also really like to complain.  And when you tell them how much it costs to simply exist in the American healthcare system without even having seen a doctor yet ($15k per year for 3 of the 4 members of our family, just in monthly premiums), they will relent and say something like "That's absolutely absurd.  Yes, I suppose our system is worth it for what you pay."

And what do we pay in medical premiums here in the Netherlands?  Well... our kids are free... because all minors, regardless of their family's income level, are covered by the government here for any and all medical care.  Nic and I pay 2,800 EUR per year, total for both of us combined, for decent insurance coverage that suits our age and health.

Thanks to David needing a stitch and a cast in the same month, through different incidents, we've got a but of direct experience in the healthcare system here, but nothing extensive.  Just like my last post about schools, this is going to be an overview of what we've observed so far and future posts will cover further detail as we use the system more in the future.

Insurance and such

Having medical insurance in the Netherlands is legally required and it's dated back to your arrival in the country when you sign up.  It's also all privatized, so the process of finding insurance is a simple internet search and then compare and narrow down the results.  The plans can be customized to have more or less coverage, specialty items (such as physical therapy), prescription coverage, dental and vision included or not, etc.  The premium costs vary depending on what you select and your age and the different companies all ended up in roughly the same range.  Nic did some research into which were the most reliable, easy to work with in terms of administration, and which had more information available in English.  Even though the kids are covered by the government, they are logged as dependents on our insurance plan and their expenses get reimbursed to our insurance provider.

How does general practice work?

The medical system here feels like I imagine it would in the US if Kaiser was blown up to a national level.  You start with your general practice doctor, they evaluate you and refer you to a specialist if-needed.  You're options for selecting a GP are limited by zip code here - clinics will only see patients within a certain postal code range, so you can't pick a practice that's across town.  This also means that if you have a specialty issue, like wanting a doctor who is trans-friendly, you're starting from a limited pool and there may not even be resources available to do research.  Overall, you're really just not supposed to care much about who your doctor is because you're supposed to be able to trust that everyone in the field is respectable and does their job well (which to the Dutch means by using extreme logic and a scientific basis for everything).  Furthermore, the field of paediatrics here only exists within specialty practices.  All GPs see adults as well as children.

So, you move to a new place, search for medical practices in your area, see who is accepting new patients, then register there.  Ask your former doctor's office to send over your files, and you're done.

I'm not terribly certain what your options are if you get referred to a specialist - we haven't had that experience, nor heard about it from others.

How do emergencies and urgent care work?

If you've got a proper emergency, there is a number to call for an ambulance just like in the US.  I don't know what the call wait or team response times are because we've never needed to call it (whew!), but what I can say is that I've never seen a fire truck show up instead of an ambulance.  

Urgent care, now that's something we have experience in!  There aren't urgent care clinics scattered all over.  In our region, there is one phone number you call for after-hours care that serves as a triage line.  My hold time was something like 20 minutes and I started as the 7th in line on a Sunday morning.  The nurse had access to all of our information once I provided identifying data because it's accessible by all clinics when you register with the government (and registration is legally required).  The nurse determined that our particular medical need couldn't be served by the clinic that runs the triage, so she called ahead to the local university medical center which had the equipment necessary.  She gave us brief instructions to get there, and we were good to go.  If this hadn't been the case, we would sadly have had to bike or bus quite a way to get to the triage clinic.

Once we got there, they already had notes on our situation.  We were seen relatively quickly, but the whole trip took 3.5-ish hours between the consultation, X-ray, analysis of the X-ray, and the cast getting done.  Our follow-up appointment for the next week to get the cast off was made for us, without consultation on our schedule or anything.  We got an e-mail as well as a proper post notice of when and where our appointment would be.  That appointment was also smooth and I think we were home within an hour.  My favorite part about that appointment is that it was in a cast-specific clinic, so everyone was there for the same thing.  Whenever a new person walked into the waiting room, everyone said good morning.  I have no idea if that's general waiting room etiquette or if it was because of the common complaint, but it was lovely.

During the 10 days that David had a cast, we had a kid's wheelchair to help us out.  The hospital didn't have any for children, so they gave me the search term I'd need to find a medical equipment rental company.  I found one, put in our basic information online, and the wheelchair was delivered to our door the next day.  For free.

In fact, everything related to David's medical care in this last month has been free.  They haven't even asked for our insurance information because kids are covered and all of the data is tied to the same database.

Hopefully you found this at least a little bit interesting!  I'll post more as we have more interactions with the system.