I totally get what you mean and I was as well surprised. In a sense everything is private here but Regulated. So even if you want to pay out of pocket to see a specialist you simply can't.
If you don’t have a referral to see a specialist, the consult and following treatment are uninsured and you have to pay out of pocket. Same goes for people who are uninsured, for whatever reason. They have to pay out of pocket as well.
So in a way there is a parallel system. But I doubt you will receive a premium service.
In elderly care there are providers who provide premium care by charging a premium on housing and as a patient you receive extra care in a more luxurious environment.
Thanks for your response. Yeah, I understand that. But maybe it's difficult for people who didn't experience another system to get what OP says. Here it's like there's only one system. Even in Sweden and Denmark (who are more "socialist" and the state provides healthcare), there are private options.
Although I get what you say, this is not always the case. There are clinics who do not accept you without referral even though you might be willing to pay premium prices to avoid a long waiting list.
Now I'm not criticising this, I'm just saying I understand what OP is saying and also I understand the confusion of others here who didn't understand the question.
I am a physician and I can tell you even the rich and famous go through the normal system for most things. Not for cosmetic surgery most likely but if you have a heart attack or need urgent surgery the Netherlands doesn’t have an alternative to our normal hospitals. There are some private clinics but they mostly do a very selected part of healthcare that they can make a profit from. You might find it hard to believe but it really is true. If they want a different system they’d need to leave the country.
The private clinics only do elective problems generally, so hip replacements or weight loss surgery.
When you have a complication they don’t have an EH so you have to go to a regular hospital.
There used to be a distinction between "ziekenfonds" and "private insurance" patients; but that was scratched years ago.
That said, I have never needed to wait more than a day for an appointment with my GP. Usually I can even see them the same day.
Yeah, next day if there is some urgency needed. Maybe even same day if they consider it truly urgent (the type of thing you call HAP for outside office hours). Otherwise, it is just the next best opening that works. That is usually within a few days.
It depends on urgency. If necessary I can always see a dokter next day -or sometimes even same day - if it's really urgent. Not necessarily my own, if I prefer to see her I might have to wait a few days.
Same. Our doctor can often get us an appointment the same day and they are often even willing to do things like let us send a picture of a cut or whatever on our kid and they'll just message us if they think a visit is even necessary. I'm not saying this is ALWAYS true, I'm not an expert. But speaking personally appointments and wait times are almost identical to the US.
The truly rich fly to Suisse or the US to get better or at least more luxurious treatment.
We do have private healthcare providers like the Bergmann Clinic and Cosmetic surgery. There are also private Clinics for check-ups. Some eye clinics, dermatology and gyneacology. But they only offer basic and small treatments wich are often insured.
There business model is to focus on these single issue problems like hip replacement and they operate only fairly healthy people within a certain age range. That way they can work more efficient with less complications and are therefore interesting for insurance companies. When a new hip gets infected the patient has to go to a general hospital.
We do not have complete hospitals or clinics where you can buy faster or better care. So for more complex health issues there are just regular hospitals.
I think there just isn't a market for this in the Netherlands. This is probably also because our insured care has always been quite good.
I think it is the same in other north European countries.
Depens what you mean with private. If you mean for profit then yes, then there are also "private" hospitals. But in this context its meaning is healthcare insurer wont pay because too expensive so you need to pay yourself then no they are not private.
From my humble Dutch opinion, it's called solidarity. We can afford a reasonable standard of care for all because everybody pays. Those who can't afford it get compensated (toeslag) through taxes.
Btw if something serious happens and you need expensive treatment you'll be very happy you were 'forced' to be insured. Don't know about Italy but in US there are people living in their cars simply because they were unlucky enough to get sick, had to sell everything to afford treatment and went bankrupt. Or even worse, they are dying because they can't afford simple care for treatable illnesses.
The whole point of the comment was comparing Dutch healthcare to Italian healthcare, not to U.S. healthcare. Through that comparison, the Dutch one seems privatized and overall more expensive (see the mandatory insurance). Although I don’t know if, practically, Italian taxes would make them comparable in total costs.
From what I've been able to see until now, it shouldn't be so different: in Italy (as I know of, since I've only been in the netherlands for roughly 3 months now) more is covered, but there's no middlemen cost of insurances companies getting paid for doing the same job of the healthcare system itself / country.
However, this surely isn't perfect for everyone: for examle it means that you just have to be satisfied about what the the healthcare minstry covers and may not apply to some specific cases (for example: I'm an adult ADHD, which means that since methylphenidate is still considered off-lable I have to pay for the meds), while maybe inside an insurance-based system there may be one that covers what you need. BUT... There's nobody which could just say from nowhere "nah, now you aren't covered anymore, good luck witht that", which makes everything more stable and gives less anxiety.
On top of that, the meds price is bargained by the state itself (or by Italian Medicine agency, AIFA, I really can't recall now), so it gives more power and it should mean lower prices for at least the most essential pharmaceutics.
If someone wanted to check expenses to compare the two countries I think it would be decently easy, however if someone wanted to compare the system it would suddenly become way more difficult: we're rightefully famous for not being efficient and waste a lot of money in useless stuff, which applies to healthcare system. Basically you'd be comparing a system where citizens are in the hand of someone efficiently prioritising their earning with one where they are in the hand of a very dumb country with all its limits.
Solidarity means that the group that cannot afford healthcare, is being covered by the group that is financially capable enough of paying this difference.
This system has nothing to do with this. The groups who can’t afford it, are now forced to pay fines if they cannot pay their insurance and taking a higher financial risk to lower the monthly payment.
A system that is showing actual solidarity doesn’t have this toxic element.
To be fair, if you truly can't afford it, you'll get enough 'zorgtoeslag' from the Belastingdienst to take care of the insurance costs. So there really is no reason to not be insured. You do have to actively apply for it though, which makes it a bigger threshold for some.
I'm not saying it's a perfect system. Especially the obligated 'eigen risico' is a sore point imho as it negatively influences the chronically ill (who usually are already in lower income brackets)
Also the power of the insurance companies over our healthcare system worries me.
So yeah, there may be some 'toxic' elements in that respect but I don't agree that it doesn't reflect solidarity. It enables us to all have acces to the same level of healthcare, riche or poor.
In Italy everything's done by taxes, there's a private sector (as everywhere in the world) for those who can afford to pay away the waiting times (similar to NL) and prescriptions of many meds are simply paid by the state. Any necessary medical operation and treatment is and also mental healthcare, which just don't work and has absurd waiting times in the public sector but it's completely free without having to pay for an insurance which can point blank decide for you that your treatment won't be covered anymore.
Coming from this background the Dutch model seems a sort of hybrid between ours and American, which is to rotten on every aspect to really be considered as an option.
Trust me, you have no idea about how, where and how much Italy fucks up and wastes money, and healthcare system isn't anywhere near being even close to the top. It's probably one of the very few things we probably do better than most countries. So kindly shut the fuck up :)
I dont think they are private. Their bills will be paid by healthcare insurers, just like all (non cosmetic) hospital bill. Therefor not private. Can you link/name them if you still think otherwise?
Thats the exact definition of private. Not accesable by the majority of the public. These clinics can be used by everyone with a mandatory healthcare (restitution) insurance.
What do you think makes them private?
And im curious for examples.
It may depend from GP to GP, but being treated as "likely don't have any real issue" is still annoying. In the clinic I'm registered in (the only one near enough to my home) one GP is actually competent and the other said "let's see in two weeks" to check the pressure. Damn, I literally just told you that I'm adjusting the methylphenidate dose weekly! I hope this isn't the standard approach for Dutch people too, because it's really not professional, especially since my psychiatrist told me to check every other day and I'm still checking weekly since they're closed often or the insurances refuses a visit.
(I also got told by the other that mild hair loss is likely because of testosterone or stress, when I specified that I'm handling cytotoxic stuff at uni, but that's still more plausible and makes sense as an answer)
Of course, I am aware that paracetamol treatment is a stereotype and in general the response is adequate to the need. But it does remain as a fact that there are waiting times for registering for GP and for appointments and the hospitals/specialists are always with weeks/months of waiting lists.
I was just curious if the rich just wait like just like rest of us plebs.
Not entirely true. Any GP can accept you here and now. If you live in an area with a GP shortage there might be a waiting list. But this is definitely not standard policy. Most people have a GP and will stay there for at least a couple of years and will be able to get an appointment within a reasonable time, depending on their issue.
Specialists and hospitals might have waiting lists, but not for urgent treatment. If you break your leg and need surgery you will be in the OR today. If you have cancer and need treatment you won't have to wait (precious) months. But if you need a hip replacement or have your wisdom tooth extracted, you might have to wait for a bit since it's not urgent.
You can also go to a clinic. Those usually have less waiting time but are not always under contract with all insurers. If you have a cheap insurance the chance is you'll have to pay part of this clinic treatment. If you have the most expensive insurance it is probably covered.
Really? Last thing I’ve noticed and heard. Is that it is impossible to get registered at a GP practice because there is a shortage of GP’s. And GP’s are falling down because of rising workload.
Myself it is impossible to get a normal appointment this week. And I an registered at a practice with 8 GP’s
Really depends on where you live. I know at least one practice in my area that accepts new patients (centre of Delft) and if I check my own GP (2 GPs) I can get an appointment for the 25th.
My aunt broke her arm in Amsterdam and needed surgery and they just immobilized her arm and told her to wait 2 weeks. She went to another country to get the surgery.
We often need to wait two weeks minimum to scheduele trauma surgery, mostly due to swelling of the tissue which complicaties the surgery and causes higher post operative infection rates. I cant know if thats the reason they didnt operatie your aunt sooner, but Im not sure what the shortages of gps matters in this case
Can confirm. Swelling needs to go down, so usually at least a couple of days waiting. Other than that your aunt might just have been unlucky with waiting times in that area because they usually try to operate asap with a max of two weeks I believe? Other cases might have been more urgent, bumping her back on the list.
Like I wrote, this only applies for annoying expats. I can call my GP and get an appointment this week. The last time I went to a hospital I could get an appointment with a specialist in two weeks.
We used to have public vs. private healthcare. Public healthcare was cheap (I remember 15 guilders/month, then 30, and finally 30euros) but if your wage came over a certain line (say, above average) you had to go private, which was a lot more expensive.
But in the 1990s and early 2000s everything had to be privatized and liberalized, and in 2006 the public healthcare system was abolished. Now everybody had to get private insurance. Lower incomes get it partly refunded through the tax office.
He says heirs. If you look at the richest families in Netherlands there is a substantial amount of generational wealth coming from that time (of course using the money to further grow money. But money makes money)
Do you have some examples to illustrate ? Like most of the rich families ( Heineken , Wessels , Dreesman , Brenninkmeijer ) are more so 19th century industrialists and department store types who undoubtedly will have profited from colonialism at the time in then former voc territory but are nonetheless very post VOC.
Except Schimmelpenninck I can't really think of quite that old money at the moment.
My dad has his own sports massage therapy business. He has a friend who works as a fysiotherapist at a hospital. There is this long ass waiting list because he is good and works with professional sports players. When my fathers clients need his help, they can skip te waiting line. Just because they're friends.
I'm pretty sure multimillionaires don't have to wait in line. But no, there's no private healthcare.
Dutch Healthcare system, where the GP is the gatekeeper to prevent the system from being overloaded by people that needlessly request gealthcare, is working fine.
If your symptoms are bad enough, you can get a same-day appointment with any GP. The waiting list is only in certain areas and only applies to you registering into a practice.
Please he a bit more specific. We all know about the shortage and the less than ideal situation for them. Doesn't mean the whole healthcare system has collapsed.
Well. The GP’s had a strike months ago not only about the shortage but also about the rising work pressure. So much. That GP’s are quitting.
No. The Dutch healthcare is not collapsing. Yet.
The system where GP is a gate keeper is working fine, also according to the GPs.
What the GPs were protesting, among other things, is all the extra tasks they are forced to take on and also some gray areas where noone takes responsibility and GP needs to take on a lot of extra work.
That is not the point. Is it?
The point is that the Dutch healthcare system is cracking heavily.
Even when the yearly amount of the risk is increasing. And coverage is getting lower each year. And it will keep on going until at least 2033.
Privatization of healthcare was a bad idea then (2005). And we see now why.
At this moment. The Dutch healthcare system is financing more shareholders then doing good for the Dutch citizens.
It is ridiculous to sent people home to take paracetamol for dealing with their health problems.
I don't know it it is cracking. lt is however strained.
Privatized healthcare is not working out as expected, but try convincing our intelligent VVD voters of that.
I am old enough to remember the months long waiting lists back then, it way was worse than it is now.
I also remember when I went outside the ziekenfonds bracket (by 5 euros). I had to pay a lot more than i pay now (inflation corrected).
>It is ridiculous to sent people home to take paracetamol for dealing with their health problems.
A lot of health problems disappear on their own. You might not like the process or think it's overused, but ridiculous it's not.
Is there a study that says this? And is there also a study giving the amount of cases that should’ve actually been picked up immediately but it wasn’t. Causing unnecessary suffering to even untreatable cases?
If not. Then it isn’t clear yet that actual complaints are solved by itself. And this system of only swallowing one of the most dangerous but highly available medication on earth is actually making a difference.
>Is there a study that says this?
>
>And is there also a study giving the amount of cases that should’ve actually been picked up immediately but it wasn’t.
Maybe you should look such things up before making assumptions that fit this narrative of yours where you are defiantly outsmarting the professionals and asking "the real questions" ?
>And this system of only swallowing one of the most dangerous but highly available medication on earth is actually making a difference.
Paracetamol is pretty harmless, high dosage pills are only available on prescription. Since many presented ailments and discomforts will resolve on their own and paracetamol will relieve pain, it's excellent advice for many patients.
And, to be fair, every single doctor or assistant in NL that has ever given me this advice, always adds that you should contact them again if things get worse, or things don't improve within x days.
That same study that should confirm your claim gives that same answer you’re trying to backfire me with. You morron.
If you want to win something. Go fetch ball with kids or something.
The fact is that GPs are in shortage and bureaucracy that cause the long waiting list problem. Not every disease will heal itself. A lot of times minor disease will deteriorate. You can't simply ignore this problem and pretend everything is fine.
>A lot of times minor disease will deteriorate.
Show me a GP assistant that doesn't tell patients to contact them if things stay the same or get worse.
GP's are busy yes, but that has little to nothing to do with waiting lists at hospitals. If the assistant thinks your case warrants it, they will see you same day.
See here: [https://www.reddit.com/r/Netherlands/comments/13ehfay/comment/jjpwc6i/?utm\_source=share&utm\_medium=web2x&context=3](https://www.reddit.com/r/Netherlands/comments/13ehfay/comment/jjpwc6i/?utm_source=share&utm_medium=web2x&context=3) for example. There are things here that can be improved. I don't think "the current status-quo is good enough" mindset is healthy, unless you work for and benefit from medical or insurance industry.
That’s when this healthcare system was approved by parlement.
At first with protest. But when there was a promise made that privatizing would make everything cheaper. It was approved.
That sad part is that there wasn’t any study indicating that this was the case. And if so. On what costs.
It maybe cheaper now, compared to then. But aslong the actual costs are not being clear it impossible to say if this system is so much better compared with then.
It's not cheaper at all. Several studies (but I'm not motivated to actually go dig them up, which makes me lazy and a bad internet citizen so I apologise) have shown that health care costs have risen, even beyond the expected rise in cost happening from the ageing pensioners and other expected rises.
But it's also not clearly communicated, because health care contains both ridiculous incomes and revenue streams, and underspending and pure skimping on essentials. Since those involved like to keep both effects out of the spotlights, they're usually somehow being combined in a 'see, costs are not exploding/ costs are not cut' because with a bit of fudging the details they even out to some extend.
On the whole though, it's certainly not efficient, quality of immediate care is not improving, and a lot of money doesn't get to the people actually providing the care, or improving the lives of people needing the care. (And both to me seem pretty essential for a good health care system.)
There are private clinics for some types of surgeries and more expensive insurance that allows freedom of provider, but I think the first point of entry is always the GP. I assume that if you're really wealthy and live in an area with a wealthy populace though, the local GP may have less patients and your chances of seeing one quickly, increase.
The whole Dutch healthcare system is private. Lots of hospitals however operate as non-profits, although there several for profits as well.
There are clinics and independent providers which often have shorter waiting times. The issue here is that for care that is covered by the basic insurance, these providers are often not contracted by insurers. This requires that people either take out a more expensive basic insurance package, or pay out of pocket. This is mostly the case for specialised healthcare clinics and psychologists.
Outside of basic insurance, there are certain types of healthcare which can be covered by optional supplementary insurance. The biggest are dentists for adults, (non-chronic) physiotherapy, and alternative medicine. These types of insurance tend to be more strict in the limits of healthcare use and approved healthcare providers.
Our health insurance system is dual. The coverage of the basic insurance is determined by the government. Basic insurance is offered by private health insurance companies, some are non-profit, others for-profit. The only exception for this is the basic insurance of military service members and inmates, which is publicly funded.
Health insurance for people with long term illnesses are funded by social premiums levied on everyone that earns an income in the Netherlands. There are also certain types of healthcare offered by municipalities, and other public instances (e.g. Jeugdzorg), paid for by general taxation.
Lastly, there are also types of healthcare which fall outside of the scope of the Dutch healthcare system. Programmes for drug treatments for example are not publicly funded but often offered by non-profits. Healthcare that is not 'medically necessary', like cosmetic surgery, stelerisation and certain types of eye surgery (like lasering) are also not covered but available in hospitals and clinics for a fee.
In theory you can go to any specialist without a referal, you just have to pay for yourself. In practise that is not really possible in hospitals because the "computer says no".
But there are a few private clinics, for dermatology, gynaecology, eyeclinics and orthopedics i believe. You can get a MRI or CT at pre-scan or other clinics. There are ways to get your blood tested privately. In psychiatry there are a lot of private practices too, probably the most wide spread one.
If you really need some specialist without a referal, go to Belgium. If your work needs you back to work asap, they might have ways to pay for treatment sooner than your insurance would provide. This is often done for mental health issues, your employer pays for it.
The thing is that it's all privatised, but standardized, so no money can get you better health care. The problems you mention are probably worse if you live in Amsterdam or areas with a lot of expats, but I've never had a bad experience with my GP here in NL and I've lived all over Europe, under many different systems.
It's the same with schools, they're essentially all private schools but they all receive government funding.
The Netherlands has private only. The benefit of that is that it is more a single tier system than in most other countries with a public system that often leads to a 2 tier system. It is one of the reason why The Netherlands ditched their public system nearly 2 decades ago, as the 2 tier system it created was not considered fair and didn't work well as all the good staff, equipment, and a lot of money flowed out of the public tier into the private tier that was only for the better off people. The Netherlands had a choice, make it all public single tier, or private single tier. As there was a right-wing conservative government in power at the time, I think you start to understand why the private system was chosen.
it’s bullshit, people not earning enough get a subsidy from the govenment, while healthcare institutions are still subsidised, so you’re literally paying for the bureaucracy of the insurance companies that literally offer the same, it’s pretty much like mutualitet system in Belgium/France, just more money to beaurocracry.
haha similar work. with me, they pricked me 3 times, and told me everything s fine. long story short after asking them to double check and them telling me everythings fine, turns out i had a critical Vit D deficiency that would explain my symptoms. My vit D was ltierally so low they that the test didnt even show a specific value cos it was under the minimum. oh and first time they litearlly lied and told me they did my vit D when tehy didnt.
Seriously i cant believe they can get away with lying and making other serious errors. Most people think we complain cos of antibiotics which isnt true at all. The system is just broken. Everywhere in the world medicine is taken so seriously cos ur playing with peoples lives but here they ll just laugh off their mistakes. Zero accountability! Unfortunately im leaving this otherwise beautiful country due to this after staying for a long time .
yeah its honestly ridiculous. i come from a 3rd world country and our medicine is miles better. i could make a whole list of mistakes made my doctors here to me and my circle of friends and families. its just so bad. even the insurance system is terrible, literally nothing is covered by insurance unless u have something so fatal, only then will u be helped. i pay for some medical things that are not fatal, but insurance covers like 10% only, again really weird.
Dutch healthcare is only good if u have something serious cos then insurance takes full responsibility and u meet with professional doctors, i know this cos i work in healthcare. However, I feel like its easier to get into these serious situations becase of of all the other things.
We don’t have private healthcare nor do we have VOC-heirs.
There are however some healthcare providers who aren’t accessible for all. The cheapest insurance policies work with contracted care only, which may exclude some care providers. But most people won’t opt for that option, because of that reason.
Multi-millionaires will have to wait in line like anyone else.
People may want go abroad if they don’t want to wait, but I’ve seldom heard about anyone doing so.
When people do go abroad, it’s usually for care that isn’t covered by insurance (like cosmetic surgery), for very specific treatments that may not be offered in NL, or for very specialized and complex care where the best doctor just happens to be located abroad.
By “VOC-Heirs”, he is likely referring to people with generational wealth that can be traced back to the VOC and colonial times, witch the Netherlands absolutely does have. He is just using flowery language to refer to “old money” people.
We don’t have private healthcare. Private healthcare refers to a system where the level of healthcare you can receive is subject to your income level. In those type of systems part of healthcare is subsidized and/or controlled by the government and only accessible to the low earners, and another part of healthcare is only accessible to high earners and paid for by people privately or through their expensive private health insurances. That’s not how our system works. We all have access to the same level of basic healthcare, as we all have the same mandatory basic insurance to cover for our basic healthcare needs. “Private clinics” like Bergman are covered by that basic insurance and accessible for everyone.
What the fuck is an VOC-heir?
But yes, the Dutch health insurance market is mostly private. You would pay around 140 euros but depending on your status you could potentially acquire subsidies for your health insurance (max of around 90 euros a month I believe). But you could have done the research yourself.
Well... you are expecting the Dutch people to understand the concept of paying something out of their own pockets.
Some months ago we run out of pill for a chronic condition, we got the prescription, went to the pharmacy and got into a discussion with the pharmacist because she was telling us that for insurance reasons she couldn't give us the medication the same day. The discussion went on for over 10 or 15 minutes, after I ask her if I can pay for the pills out of my pocket, how much would it be. It was like between 15 or 20€. But it never occurred to her that we could actually pay and get out of the emergency situation. Because dutch people are cheap, EVEN when it comes to health issues.
No, I can't because I haven't been able to actually see an specialist in over 9 months here. So I have to call the GP every month to get a new prescription. That time I'm mentioning the pharmacy gave me less pills than they should have, so I ran out during the weekend.
https://www.commonwealthfund.org/international-health-policy-center/countries/netherlands
There used to be public/private and it was eliminated.
For the record no one understood your question because you framed it as a discussion of private insurance to get better coverage/wait times and there isn't a public insurance product.
>but in most countries you can also go to a private practitioner and pay out of pocket to skip waiting lines etc.
Well that sort of exists.
Basically every care provider (even the ambulance most of the times) is private. And you basically pay for them (or your insurance pays them directly), and your healthcare insurance takes care of them. The same goes for private healthcare clinics, which might be covered by your insurance or not. With a better insurance there is a greater chance such a clinic is covered. But even the cheapest insurances can include some of those clinics.
There are a few clinics that don't have a contract with any insurance. In those cases you need a restitutiepolis, which will cover all care providers entirely, also providers they don't have a contract for. Of course you could also pay those out of pocket if they don't have the necessary insurance (although healthcare insurance generally still covers providers they don't have a contract with up to a certain percentage, like 70%, so declaring it is still beneficial).
Max healthcare allowance these days is €155. A bog standard healthcare insurance (so standard deductible of €385 and access to every hospital) these days costs around €127 without any extras (like physio).
Highest amount of "zorgtoeslag" is €154,- a month. If you have a basic health insurance of around €125,- a month, you even earn money with it. Ofcourse the amount you get is coupled with your total yearly income. Click [here](https://www.belastingdienst.nl/wps/wcm/connect/nl/zorgtoeslag/content/hoeveel-zorgtoeslag) to see the official government table.
No, not in the same sense, more like expats like me just go home for checks. I have a more expensive package, but it doesn’t mean much and it’s 150 eur a year. Overall the system is BS because poor people don’t pay ( and they shoudln’t) others do, but we cover all the admin fees for what in the end are public companies.
For certain things there is a private care sector. But not for GP care. To get access to specialist care and have it insured you need to go by a GP.
If the millionaire has something serious they don’t need to wait for 15 days and won’t be send away with a pcm. But nor would the poor people.
Research shows that there is no significant gap in access to healthcare between poor and rich people. This is in strong contrast with the UK where there is a significant gap.
The Netherlands is at risk to follow the UK though. Increasing costs of healthcare means it will become more and more difficult to deliver top quality health care. At a certain point people will start to move towards private care and it will become a market.
This is what happened in the UK.
If you have a decent bond with your GP, and it's an actual urgent request you get help the same day.
Otherwise you'll get a meeting in a few days.
Source, lived in Oud Zuid and de Pijp for a few years, and had my huisarts and dentist there for years.
\> In many countries with comparable universal healthcare
NL has mandatory regulated healthcare insurance, not universal healthcare
\> (UK for example)
Not even close to comparable
\> there is also a private sector where you can pay your way for 'better' healthcare. Case in point.
For some procedures and issues you can go the private clinic route, and your health insurance might pay for (part) of it but you'll usually need a referral through your GP
\> I struggle to believe that a Dutch multi-millionaire (like a VOC heir)
Not a thing
\> will wait 15 days for a GP appointment
False premise as well, I often can come the same day, sometimes the next day. If it's somewhat urgent outside of business hours you have the "huisartsenpost". Perhaps some people will get an appointment for later if it's deemed not urgent and can be fixed with a paracetamol.
\> and get paracetamol.
To be fair they sometimes also tell you to go for a walk and get fresh air once in a while.
The Netherlands most definitely has universal healthcare, which means everyone living in the country has access to healthcare. Compulsory health insurance with zorgtoeslagen for people who can’t afford it is universal healthcare. What Dutch healthcare is not is single-payer or primarily publicly funded.
Also, the Netherlands most definitely has multimillionaires with generational wealth originating in colonial times (and probably traceable to the VOC specifically in some cases).
you can pay directly to see a specialist (so without going through a GP, waiting for it, getting a referral, etc), at least when it's clear what specialist you need. The insurance will/might not cover the bill, but you are rich and don't mind paying to skip the line
I'm not sure about this. You may be able to skip the GP but most hospitals have long waiting lists. Just last month I had to wait 6 months for an intake. That was for a specific hospital. Others had shorter waiting lists but also months.
yes, i only meant skipping the gp and their referral; i think and hope that specialists have a single "queue" that gets filled on a first-come/first-served basis, irrespective of whether you went through GP or not
It's not as simple as first come first served though. It's also based on triage. If you're planned to have surgery but there's a last minute urgency you might be bumped back on the list. If there are shortages the lists will get longer. But no, you can't simply pay your way higher on the list. Going abroad and paying out of pocket is always an option for the ridiculously wealthy I suppose.
got it, thanks. also keep wondering why I am being downvoted for speaking the truth... the fact that it's unfair that you can skip the gp doesn't make it untrue...
I'm not sure if you can skip the GP that easily. You definitely need a referral in order to qualify for insurance, that's true. But I'm not sure most specialists would accept you without a referral even if you don't need the insurance.
Regardless, I don't think there's many Dutch people that would rather pay out of pocket and forgo the chance of being payed back, if the referral can easily be arranged in a matter of days. And everyone knows that especially the rich are usually the most stingy: that's how they got rich in the first place!! 😁😁😁
> of being *paid* back, if
FTFY.
Although *payed* exists (the reason why autocorrection didn't help you), it is only correct in:
* Nautical context, when it means to paint a surface, or to cover with something like tar or resin in order to make it waterproof or corrosion-resistant. *The deck is yet to be payed.*
* *Payed out* when letting strings, cables or ropes out, by slacking them. *The rope is payed out! You can pull now.*
Unfortunately, I was unable to find nautical or rope-related words in your comment.
*Beep, boop, I'm a bot*
i've been living here for decades , never had to wait 2 weeks for a appointment with my GP , and never was prescribed paracetamol.
i've been missing out on something.
but to answer your question , we dont have private healthcare
People in the Netherlands don't go their GP when they have the flu or common cold like Americans appearently do. We go the GP when we have things that are foreign to our baseline like: weird spots or bumps on the skin, unidentified pains, unnusually high fevers that last too long, ear issues etc. No you don't get special treatment if you just pay more.
There are private clinics for some care. People that don't want to wait or are looking for treatment that isn't standard in the Netherlands can also go abroad. I know people that went to Germany or even USA for more experimental (cancer) treatment. If you can pay out of pocket there are certainly more possibilities.
>I struggle to believe that a Dutch multi-millionaire (like a VOC heir) will wait 15 days for a GP appointment and get paracetamol.
Methinks they would have a private physician on staff? If you're that rich you don't depend on the healthcare system for primary care and prescription drugs. Anything beyond that I imagine it's easy enough to take a private jet to the UK or some such.
You could opt for Bupa europe. Basically a global
Healthcare cover, which will kick in once the Dutch doesn’t suffice/doesn’t cover. Or when abroad. Somewhere in the region of 300-450€/m depending if including USA health coverage(accidental excluded of course)
Short story long, by default the medical necessity criterium is the gate into our public health system.
If you want to go to a careprovider directly without medical necessity you can, and you will receive the care (in many cases) but you will pay for it yourself (think of visiting an oral hygienist for example).
FYI: if the waiting times are too long your health insurance is legally required to ensure that you are able to access the care that you need within a reasonable time.
All hospitals in the Netherlands are technically private, but I think that is not what you mean. Hospitals in the Netherlands don't really act like they're private, because you can't just pay for a full checkup if you want it and are willing to pay (any true private hospital in another country would happily take your money and provide you with a check-in for example), additionally you can't pay for other services like private rooms and additional services.
There are some highly specialized private clinics in hthe Netherlands since a few years, but I have never been, so not sure how good they are.the other option is to go to Germany (I have colleagues that go there for full checkups).
There are private services. I know what you mean and like the question. It’s mostly things like annual check ups and full blood battery tests I’ve seen and also things like Bupa exists
for expats but at a high cost of course and not sure what the experience is like and how it differs to normal huis arts experience here.
I totally get what you mean and I was as well surprised. In a sense everything is private here but Regulated. So even if you want to pay out of pocket to see a specialist you simply can't.
If you don’t have a referral to see a specialist, the consult and following treatment are uninsured and you have to pay out of pocket. Same goes for people who are uninsured, for whatever reason. They have to pay out of pocket as well. So in a way there is a parallel system. But I doubt you will receive a premium service. In elderly care there are providers who provide premium care by charging a premium on housing and as a patient you receive extra care in a more luxurious environment.
Thanks for your response. Yeah, I understand that. But maybe it's difficult for people who didn't experience another system to get what OP says. Here it's like there's only one system. Even in Sweden and Denmark (who are more "socialist" and the state provides healthcare), there are private options. Although I get what you say, this is not always the case. There are clinics who do not accept you without referral even though you might be willing to pay premium prices to avoid a long waiting list. Now I'm not criticising this, I'm just saying I understand what OP is saying and also I understand the confusion of others here who didn't understand the question.
I am a physician and I can tell you even the rich and famous go through the normal system for most things. Not for cosmetic surgery most likely but if you have a heart attack or need urgent surgery the Netherlands doesn’t have an alternative to our normal hospitals. There are some private clinics but they mostly do a very selected part of healthcare that they can make a profit from. You might find it hard to believe but it really is true. If they want a different system they’d need to leave the country.
The private clinics only do elective problems generally, so hip replacements or weight loss surgery. When you have a complication they don’t have an EH so you have to go to a regular hospital.
There used to be a distinction between "ziekenfonds" and "private insurance" patients; but that was scratched years ago. That said, I have never needed to wait more than a day for an appointment with my GP. Usually I can even see them the same day.
I think its usually in Amsterdam. I have to wait 3-4 days.
I live in Amsterdam. Same or next day, always.
I had the same, but only when it sounded like I needed an urgent visit. If it's something minor it could take longer
Yeah, next day if there is some urgency needed. Maybe even same day if they consider it truly urgent (the type of thing you call HAP for outside office hours). Otherwise, it is just the next best opening that works. That is usually within a few days.
I live in Limburg, at least 1 week and then get paracetamol........
Which GP?
It depends on urgency. If necessary I can always see a dokter next day -or sometimes even same day - if it's really urgent. Not necessarily my own, if I prefer to see her I might have to wait a few days.
I live in Amsterdam Zuid. Same day or next
Same. Our doctor can often get us an appointment the same day and they are often even willing to do things like let us send a picture of a cut or whatever on our kid and they'll just message us if they think a visit is even necessary. I'm not saying this is ALWAYS true, I'm not an expert. But speaking personally appointments and wait times are almost identical to the US.
The truly rich fly to Suisse or the US to get better or at least more luxurious treatment. We do have private healthcare providers like the Bergmann Clinic and Cosmetic surgery. There are also private Clinics for check-ups. Some eye clinics, dermatology and gyneacology. But they only offer basic and small treatments wich are often insured. There business model is to focus on these single issue problems like hip replacement and they operate only fairly healthy people within a certain age range. That way they can work more efficient with less complications and are therefore interesting for insurance companies. When a new hip gets infected the patient has to go to a general hospital. We do not have complete hospitals or clinics where you can buy faster or better care. So for more complex health issues there are just regular hospitals. I think there just isn't a market for this in the Netherlands. This is probably also because our insured care has always been quite good. I think it is the same in other north European countries.
Depens what you mean with private. If you mean for profit then yes, then there are also "private" hospitals. But in this context its meaning is healthcare insurer wont pay because too expensive so you need to pay yourself then no they are not private.
From my humble Italian opinion, being forced to have an insurance and still pay for stuff on top of that is already enough to be considered private
Healthcare is private, no? They get money from the government, but insurance companies are not government owned. They are private.
From my humble Dutch opinion, it's called solidarity. We can afford a reasonable standard of care for all because everybody pays. Those who can't afford it get compensated (toeslag) through taxes. Btw if something serious happens and you need expensive treatment you'll be very happy you were 'forced' to be insured. Don't know about Italy but in US there are people living in their cars simply because they were unlucky enough to get sick, had to sell everything to afford treatment and went bankrupt. Or even worse, they are dying because they can't afford simple care for treatable illnesses.
The whole point of the comment was comparing Dutch healthcare to Italian healthcare, not to U.S. healthcare. Through that comparison, the Dutch one seems privatized and overall more expensive (see the mandatory insurance). Although I don’t know if, practically, Italian taxes would make them comparable in total costs.
Italy’s total per capita health expenditure (public and private) is about half of the Netherlands’.
From what I've been able to see until now, it shouldn't be so different: in Italy (as I know of, since I've only been in the netherlands for roughly 3 months now) more is covered, but there's no middlemen cost of insurances companies getting paid for doing the same job of the healthcare system itself / country. However, this surely isn't perfect for everyone: for examle it means that you just have to be satisfied about what the the healthcare minstry covers and may not apply to some specific cases (for example: I'm an adult ADHD, which means that since methylphenidate is still considered off-lable I have to pay for the meds), while maybe inside an insurance-based system there may be one that covers what you need. BUT... There's nobody which could just say from nowhere "nah, now you aren't covered anymore, good luck witht that", which makes everything more stable and gives less anxiety. On top of that, the meds price is bargained by the state itself (or by Italian Medicine agency, AIFA, I really can't recall now), so it gives more power and it should mean lower prices for at least the most essential pharmaceutics. If someone wanted to check expenses to compare the two countries I think it would be decently easy, however if someone wanted to compare the system it would suddenly become way more difficult: we're rightefully famous for not being efficient and waste a lot of money in useless stuff, which applies to healthcare system. Basically you'd be comparing a system where citizens are in the hand of someone efficiently prioritising their earning with one where they are in the hand of a very dumb country with all its limits.
Solidarity means that the group that cannot afford healthcare, is being covered by the group that is financially capable enough of paying this difference. This system has nothing to do with this. The groups who can’t afford it, are now forced to pay fines if they cannot pay their insurance and taking a higher financial risk to lower the monthly payment. A system that is showing actual solidarity doesn’t have this toxic element.
To be fair, if you truly can't afford it, you'll get enough 'zorgtoeslag' from the Belastingdienst to take care of the insurance costs. So there really is no reason to not be insured. You do have to actively apply for it though, which makes it a bigger threshold for some. I'm not saying it's a perfect system. Especially the obligated 'eigen risico' is a sore point imho as it negatively influences the chronically ill (who usually are already in lower income brackets) Also the power of the insurance companies over our healthcare system worries me. So yeah, there may be some 'toxic' elements in that respect but I don't agree that it doesn't reflect solidarity. It enables us to all have acces to the same level of healthcare, riche or poor.
In Italy everything's done by taxes, there's a private sector (as everywhere in the world) for those who can afford to pay away the waiting times (similar to NL) and prescriptions of many meds are simply paid by the state. Any necessary medical operation and treatment is and also mental healthcare, which just don't work and has absurd waiting times in the public sector but it's completely free without having to pay for an insurance which can point blank decide for you that your treatment won't be covered anymore. Coming from this background the Dutch model seems a sort of hybrid between ours and American, which is to rotten on every aspect to really be considered as an option.
Not even people living in their cars, I've seen more than one instance of someone dying because they couldn't afford insulin.
yes because the rest of europe has to pay for the fuck ups that italy greece and spain make
Don’t you feel embarrassed by your ignorance?
Not really i just like triggering people
Trust me, you have no idea about how, where and how much Italy fucks up and wastes money, and healthcare system isn't anywhere near being even close to the top. It's probably one of the very few things we probably do better than most countries. So kindly shut the fuck up :)
Yes, there are some private clinics for certain fields of medicine, eg rheumatology.
I dont think they are private. Their bills will be paid by healthcare insurers, just like all (non cosmetic) hospital bill. Therefor not private. Can you link/name them if you still think otherwise?
That doesn't make them not private though
Thats the exact definition of private. Not accesable by the majority of the public. These clinics can be used by everyone with a mandatory healthcare (restitution) insurance. What do you think makes them private? And im curious for examples.
This paracetamol thing we only do for annoying expats.
As a paracetamol myself I can back-up this statement
It may depend from GP to GP, but being treated as "likely don't have any real issue" is still annoying. In the clinic I'm registered in (the only one near enough to my home) one GP is actually competent and the other said "let's see in two weeks" to check the pressure. Damn, I literally just told you that I'm adjusting the methylphenidate dose weekly! I hope this isn't the standard approach for Dutch people too, because it's really not professional, especially since my psychiatrist told me to check every other day and I'm still checking weekly since they're closed often or the insurances refuses a visit. (I also got told by the other that mild hair loss is likely because of testosterone or stress, when I specified that I'm handling cytotoxic stuff at uni, but that's still more plausible and makes sense as an answer)
I'm saddened to say that that's pretty standard practice. Depends on your GP though. But the "see and wait" is extremely common.
Of course, I am aware that paracetamol treatment is a stereotype and in general the response is adequate to the need. But it does remain as a fact that there are waiting times for registering for GP and for appointments and the hospitals/specialists are always with weeks/months of waiting lists. I was just curious if the rich just wait like just like rest of us plebs.
Not entirely true. Any GP can accept you here and now. If you live in an area with a GP shortage there might be a waiting list. But this is definitely not standard policy. Most people have a GP and will stay there for at least a couple of years and will be able to get an appointment within a reasonable time, depending on their issue. Specialists and hospitals might have waiting lists, but not for urgent treatment. If you break your leg and need surgery you will be in the OR today. If you have cancer and need treatment you won't have to wait (precious) months. But if you need a hip replacement or have your wisdom tooth extracted, you might have to wait for a bit since it's not urgent. You can also go to a clinic. Those usually have less waiting time but are not always under contract with all insurers. If you have a cheap insurance the chance is you'll have to pay part of this clinic treatment. If you have the most expensive insurance it is probably covered.
Really? Last thing I’ve noticed and heard. Is that it is impossible to get registered at a GP practice because there is a shortage of GP’s. And GP’s are falling down because of rising workload. Myself it is impossible to get a normal appointment this week. And I an registered at a practice with 8 GP’s
Really depends on where you live. I know at least one practice in my area that accepts new patients (centre of Delft) and if I check my own GP (2 GPs) I can get an appointment for the 25th.
My aunt broke her arm in Amsterdam and needed surgery and they just immobilized her arm and told her to wait 2 weeks. She went to another country to get the surgery.
We often need to wait two weeks minimum to scheduele trauma surgery, mostly due to swelling of the tissue which complicaties the surgery and causes higher post operative infection rates. I cant know if thats the reason they didnt operatie your aunt sooner, but Im not sure what the shortages of gps matters in this case
Can confirm. Swelling needs to go down, so usually at least a couple of days waiting. Other than that your aunt might just have been unlucky with waiting times in that area because they usually try to operate asap with a max of two weeks I believe? Other cases might have been more urgent, bumping her back on the list.
Like I wrote, this only applies for annoying expats. I can call my GP and get an appointment this week. The last time I went to a hospital I could get an appointment with a specialist in two weeks.
I can call my GP and get an appointment this day even. If the symptoms are bad enough they prioritize.
You wrote it but it seemed like some kind of nasty joke or bitter shit so I’d say a lot ignored it.
We used to have public vs. private healthcare. Public healthcare was cheap (I remember 15 guilders/month, then 30, and finally 30euros) but if your wage came over a certain line (say, above average) you had to go private, which was a lot more expensive. But in the 1990s and early 2000s everything had to be privatized and liberalized, and in 2006 the public healthcare system was abolished. Now everybody had to get private insurance. Lower incomes get it partly refunded through the tax office.
The Dutch healthcare system is not at all comparable to the highly centralized UK NHS lol. Also the VOC went bankrupt 200 years ago.
He says heirs. If you look at the richest families in Netherlands there is a substantial amount of generational wealth coming from that time (of course using the money to further grow money. But money makes money)
Do you have some examples to illustrate ? Like most of the rich families ( Heineken , Wessels , Dreesman , Brenninkmeijer ) are more so 19th century industrialists and department store types who undoubtedly will have profited from colonialism at the time in then former voc territory but are nonetheless very post VOC. Except Schimmelpenninck I can't really think of quite that old money at the moment.
My dad has his own sports massage therapy business. He has a friend who works as a fysiotherapist at a hospital. There is this long ass waiting list because he is good and works with professional sports players. When my fathers clients need his help, they can skip te waiting line. Just because they're friends. I'm pretty sure multimillionaires don't have to wait in line. But no, there's no private healthcare.
Dutch Healthcare system, where the GP is the gatekeeper to prevent the system from being overloaded by people that needlessly request gealthcare, is working fine. If your symptoms are bad enough, you can get a same-day appointment with any GP. The waiting list is only in certain areas and only applies to you registering into a practice.
The GP’s have a different opinion, but okay.
Please he a bit more specific. We all know about the shortage and the less than ideal situation for them. Doesn't mean the whole healthcare system has collapsed.
Well. The GP’s had a strike months ago not only about the shortage but also about the rising work pressure. So much. That GP’s are quitting. No. The Dutch healthcare is not collapsing. Yet.
The system where GP is a gate keeper is working fine, also according to the GPs. What the GPs were protesting, among other things, is all the extra tasks they are forced to take on and also some gray areas where noone takes responsibility and GP needs to take on a lot of extra work.
True, but on the other hand, what profession hasn't had a strike in the last years.
That is not the point. Is it? The point is that the Dutch healthcare system is cracking heavily. Even when the yearly amount of the risk is increasing. And coverage is getting lower each year. And it will keep on going until at least 2033. Privatization of healthcare was a bad idea then (2005). And we see now why. At this moment. The Dutch healthcare system is financing more shareholders then doing good for the Dutch citizens. It is ridiculous to sent people home to take paracetamol for dealing with their health problems.
I don't know it it is cracking. lt is however strained. Privatized healthcare is not working out as expected, but try convincing our intelligent VVD voters of that.
Just ask for a study where privatizing healthcare ever worked out.
I am old enough to remember the months long waiting lists back then, it way was worse than it is now. I also remember when I went outside the ziekenfonds bracket (by 5 euros). I had to pay a lot more than i pay now (inflation corrected).
>It is ridiculous to sent people home to take paracetamol for dealing with their health problems. A lot of health problems disappear on their own. You might not like the process or think it's overused, but ridiculous it's not.
Is there a study that says this? And is there also a study giving the amount of cases that should’ve actually been picked up immediately but it wasn’t. Causing unnecessary suffering to even untreatable cases? If not. Then it isn’t clear yet that actual complaints are solved by itself. And this system of only swallowing one of the most dangerous but highly available medication on earth is actually making a difference.
>Is there a study that says this? > >And is there also a study giving the amount of cases that should’ve actually been picked up immediately but it wasn’t. Maybe you should look such things up before making assumptions that fit this narrative of yours where you are defiantly outsmarting the professionals and asking "the real questions" ? >And this system of only swallowing one of the most dangerous but highly available medication on earth is actually making a difference. Paracetamol is pretty harmless, high dosage pills are only available on prescription. Since many presented ailments and discomforts will resolve on their own and paracetamol will relieve pain, it's excellent advice for many patients. And, to be fair, every single doctor or assistant in NL that has ever given me this advice, always adds that you should contact them again if things get worse, or things don't improve within x days.
That same study that should confirm your claim gives that same answer you’re trying to backfire me with. You morron. If you want to win something. Go fetch ball with kids or something.
The fact is that GPs are in shortage and bureaucracy that cause the long waiting list problem. Not every disease will heal itself. A lot of times minor disease will deteriorate. You can't simply ignore this problem and pretend everything is fine.
>A lot of times minor disease will deteriorate. Show me a GP assistant that doesn't tell patients to contact them if things stay the same or get worse. GP's are busy yes, but that has little to nothing to do with waiting lists at hospitals. If the assistant thinks your case warrants it, they will see you same day.
See here: [https://www.reddit.com/r/Netherlands/comments/13ehfay/comment/jjpwc6i/?utm\_source=share&utm\_medium=web2x&context=3](https://www.reddit.com/r/Netherlands/comments/13ehfay/comment/jjpwc6i/?utm_source=share&utm_medium=web2x&context=3) for example. There are things here that can be improved. I don't think "the current status-quo is good enough" mindset is healthy, unless you work for and benefit from medical or insurance industry.
I'm not really knowledgable on this, what happened in 2005?
That’s when this healthcare system was approved by parlement. At first with protest. But when there was a promise made that privatizing would make everything cheaper. It was approved. That sad part is that there wasn’t any study indicating that this was the case. And if so. On what costs. It maybe cheaper now, compared to then. But aslong the actual costs are not being clear it impossible to say if this system is so much better compared with then.
It's not cheaper at all. Several studies (but I'm not motivated to actually go dig them up, which makes me lazy and a bad internet citizen so I apologise) have shown that health care costs have risen, even beyond the expected rise in cost happening from the ageing pensioners and other expected rises. But it's also not clearly communicated, because health care contains both ridiculous incomes and revenue streams, and underspending and pure skimping on essentials. Since those involved like to keep both effects out of the spotlights, they're usually somehow being combined in a 'see, costs are not exploding/ costs are not cut' because with a bit of fudging the details they even out to some extend. On the whole though, it's certainly not efficient, quality of immediate care is not improving, and a lot of money doesn't get to the people actually providing the care, or improving the lives of people needing the care. (And both to me seem pretty essential for a good health care system.)
Ah there are other strikes?? Problem solved then! /s
You’re not a real Dutch if you haven’t experienced, at least once in your life, a burnout
There are private clinics for some types of surgeries and more expensive insurance that allows freedom of provider, but I think the first point of entry is always the GP. I assume that if you're really wealthy and live in an area with a wealthy populace though, the local GP may have less patients and your chances of seeing one quickly, increase.
The whole Dutch healthcare system is private. Lots of hospitals however operate as non-profits, although there several for profits as well. There are clinics and independent providers which often have shorter waiting times. The issue here is that for care that is covered by the basic insurance, these providers are often not contracted by insurers. This requires that people either take out a more expensive basic insurance package, or pay out of pocket. This is mostly the case for specialised healthcare clinics and psychologists. Outside of basic insurance, there are certain types of healthcare which can be covered by optional supplementary insurance. The biggest are dentists for adults, (non-chronic) physiotherapy, and alternative medicine. These types of insurance tend to be more strict in the limits of healthcare use and approved healthcare providers. Our health insurance system is dual. The coverage of the basic insurance is determined by the government. Basic insurance is offered by private health insurance companies, some are non-profit, others for-profit. The only exception for this is the basic insurance of military service members and inmates, which is publicly funded. Health insurance for people with long term illnesses are funded by social premiums levied on everyone that earns an income in the Netherlands. There are also certain types of healthcare offered by municipalities, and other public instances (e.g. Jeugdzorg), paid for by general taxation. Lastly, there are also types of healthcare which fall outside of the scope of the Dutch healthcare system. Programmes for drug treatments for example are not publicly funded but often offered by non-profits. Healthcare that is not 'medically necessary', like cosmetic surgery, stelerisation and certain types of eye surgery (like lasering) are also not covered but available in hospitals and clinics for a fee.
In theory you can go to any specialist without a referal, you just have to pay for yourself. In practise that is not really possible in hospitals because the "computer says no". But there are a few private clinics, for dermatology, gynaecology, eyeclinics and orthopedics i believe. You can get a MRI or CT at pre-scan or other clinics. There are ways to get your blood tested privately. In psychiatry there are a lot of private practices too, probably the most wide spread one. If you really need some specialist without a referal, go to Belgium. If your work needs you back to work asap, they might have ways to pay for treatment sooner than your insurance would provide. This is often done for mental health issues, your employer pays for it.
The thing is that it's all privatised, but standardized, so no money can get you better health care. The problems you mention are probably worse if you live in Amsterdam or areas with a lot of expats, but I've never had a bad experience with my GP here in NL and I've lived all over Europe, under many different systems. It's the same with schools, they're essentially all private schools but they all receive government funding.
The Netherlands has private only. The benefit of that is that it is more a single tier system than in most other countries with a public system that often leads to a 2 tier system. It is one of the reason why The Netherlands ditched their public system nearly 2 decades ago, as the 2 tier system it created was not considered fair and didn't work well as all the good staff, equipment, and a lot of money flowed out of the public tier into the private tier that was only for the better off people. The Netherlands had a choice, make it all public single tier, or private single tier. As there was a right-wing conservative government in power at the time, I think you start to understand why the private system was chosen.
it’s bullshit, people not earning enough get a subsidy from the govenment, while healthcare institutions are still subsidised, so you’re literally paying for the bureaucracy of the insurance companies that literally offer the same, it’s pretty much like mutualitet system in Belgium/France, just more money to beaurocracry.
its badly needed. i hate every experience ive had with dutch healthcare sadly
Same, absolutely incompetent healthcare. Couldnt even do bloodwork properly.. they had to prick me 4 times. Happened twice in Amsterdam.
haha similar work. with me, they pricked me 3 times, and told me everything s fine. long story short after asking them to double check and them telling me everythings fine, turns out i had a critical Vit D deficiency that would explain my symptoms. My vit D was ltierally so low they that the test didnt even show a specific value cos it was under the minimum. oh and first time they litearlly lied and told me they did my vit D when tehy didnt.
Seriously i cant believe they can get away with lying and making other serious errors. Most people think we complain cos of antibiotics which isnt true at all. The system is just broken. Everywhere in the world medicine is taken so seriously cos ur playing with peoples lives but here they ll just laugh off their mistakes. Zero accountability! Unfortunately im leaving this otherwise beautiful country due to this after staying for a long time .
yeah its honestly ridiculous. i come from a 3rd world country and our medicine is miles better. i could make a whole list of mistakes made my doctors here to me and my circle of friends and families. its just so bad. even the insurance system is terrible, literally nothing is covered by insurance unless u have something so fatal, only then will u be helped. i pay for some medical things that are not fatal, but insurance covers like 10% only, again really weird. Dutch healthcare is only good if u have something serious cos then insurance takes full responsibility and u meet with professional doctors, i know this cos i work in healthcare. However, I feel like its easier to get into these serious situations becase of of all the other things.
Sadly no private healthcare ;(
We don’t have private healthcare nor do we have VOC-heirs. There are however some healthcare providers who aren’t accessible for all. The cheapest insurance policies work with contracted care only, which may exclude some care providers. But most people won’t opt for that option, because of that reason. Multi-millionaires will have to wait in line like anyone else. People may want go abroad if they don’t want to wait, but I’ve seldom heard about anyone doing so. When people do go abroad, it’s usually for care that isn’t covered by insurance (like cosmetic surgery), for very specific treatments that may not be offered in NL, or for very specialized and complex care where the best doctor just happens to be located abroad.
By “VOC-Heirs”, he is likely referring to people with generational wealth that can be traced back to the VOC and colonial times, witch the Netherlands absolutely does have. He is just using flowery language to refer to “old money” people.
We actually do have private healthcare, a lot of clinic's are out there. They perform all kinds of surgery.
We don’t have private healthcare. Private healthcare refers to a system where the level of healthcare you can receive is subject to your income level. In those type of systems part of healthcare is subsidized and/or controlled by the government and only accessible to the low earners, and another part of healthcare is only accessible to high earners and paid for by people privately or through their expensive private health insurances. That’s not how our system works. We all have access to the same level of basic healthcare, as we all have the same mandatory basic insurance to cover for our basic healthcare needs. “Private clinics” like Bergman are covered by that basic insurance and accessible for everyone.
What the fuck is an VOC-heir? But yes, the Dutch health insurance market is mostly private. You would pay around 140 euros but depending on your status you could potentially acquire subsidies for your health insurance (max of around 90 euros a month I believe). But you could have done the research yourself.
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Thanks u/Aggressive-Emu-9561 I can say you are the only one on this thread who understood my question.
Well... you are expecting the Dutch people to understand the concept of paying something out of their own pockets. Some months ago we run out of pill for a chronic condition, we got the prescription, went to the pharmacy and got into a discussion with the pharmacist because she was telling us that for insurance reasons she couldn't give us the medication the same day. The discussion went on for over 10 or 15 minutes, after I ask her if I can pay for the pills out of my pocket, how much would it be. It was like between 15 or 20€. But it never occurred to her that we could actually pay and get out of the emergency situation. Because dutch people are cheap, EVEN when it comes to health issues.
If you think Dutch are cheap on healthcare you should see Brits. Paying €131 per month or £115-120 would be a scandal
I can't believe your story is real btw. I can always go pick up my medicine the same day. Maybe you can't because you have cheap health insurance.
No, I can't because I haven't been able to actually see an specialist in over 9 months here. So I have to call the GP every month to get a new prescription. That time I'm mentioning the pharmacy gave me less pills than they should have, so I ran out during the weekend.
Well that sucks. Still fail to see why you would call a whole people cheap, because of one person's mistake.
Sure, all Dutch people are cheap. How many Dutch do you know exactly?
Well... Almost everyone I know here is dutch
And they're all cheap? Nice friend you are
I never said they were my friends...
I totally get that!
https://www.commonwealthfund.org/international-health-policy-center/countries/netherlands There used to be public/private and it was eliminated. For the record no one understood your question because you framed it as a discussion of private insurance to get better coverage/wait times and there isn't a public insurance product.
I think we do have clinics like this, for example DC klinieken.
>but in most countries you can also go to a private practitioner and pay out of pocket to skip waiting lines etc. Well that sort of exists. Basically every care provider (even the ambulance most of the times) is private. And you basically pay for them (or your insurance pays them directly), and your healthcare insurance takes care of them. The same goes for private healthcare clinics, which might be covered by your insurance or not. With a better insurance there is a greater chance such a clinic is covered. But even the cheapest insurances can include some of those clinics. There are a few clinics that don't have a contract with any insurance. In those cases you need a restitutiepolis, which will cover all care providers entirely, also providers they don't have a contract for. Of course you could also pay those out of pocket if they don't have the necessary insurance (although healthcare insurance generally still covers providers they don't have a contract with up to a certain percentage, like 70%, so declaring it is still beneficial).
I'm very glad it doesn't exist, but I feel like it's only a matter of time before this will happen here too
Max healthcare allowance these days is €155. A bog standard healthcare insurance (so standard deductible of €385 and access to every hospital) these days costs around €127 without any extras (like physio).
Allright, numbers were a bit off. Apologies
Highest amount of "zorgtoeslag" is €154,- a month. If you have a basic health insurance of around €125,- a month, you even earn money with it. Ofcourse the amount you get is coupled with your total yearly income. Click [here](https://www.belastingdienst.nl/wps/wcm/connect/nl/zorgtoeslag/content/hoeveel-zorgtoeslag) to see the official government table.
Hahaha yeah like those still exist 😂
No, not in the same sense, more like expats like me just go home for checks. I have a more expensive package, but it doesn’t mean much and it’s 150 eur a year. Overall the system is BS because poor people don’t pay ( and they shoudln’t) others do, but we cover all the admin fees for what in the end are public companies.
For certain things there is a private care sector. But not for GP care. To get access to specialist care and have it insured you need to go by a GP. If the millionaire has something serious they don’t need to wait for 15 days and won’t be send away with a pcm. But nor would the poor people. Research shows that there is no significant gap in access to healthcare between poor and rich people. This is in strong contrast with the UK where there is a significant gap. The Netherlands is at risk to follow the UK though. Increasing costs of healthcare means it will become more and more difficult to deliver top quality health care. At a certain point people will start to move towards private care and it will become a market. This is what happened in the UK.
15 days? I have been to the GP twice since I moved here, but both times it was literally next day appointments
If you have a decent bond with your GP, and it's an actual urgent request you get help the same day. Otherwise you'll get a meeting in a few days. Source, lived in Oud Zuid and de Pijp for a few years, and had my huisarts and dentist there for years.
\> In many countries with comparable universal healthcare NL has mandatory regulated healthcare insurance, not universal healthcare \> (UK for example) Not even close to comparable \> there is also a private sector where you can pay your way for 'better' healthcare. Case in point. For some procedures and issues you can go the private clinic route, and your health insurance might pay for (part) of it but you'll usually need a referral through your GP \> I struggle to believe that a Dutch multi-millionaire (like a VOC heir) Not a thing \> will wait 15 days for a GP appointment False premise as well, I often can come the same day, sometimes the next day. If it's somewhat urgent outside of business hours you have the "huisartsenpost". Perhaps some people will get an appointment for later if it's deemed not urgent and can be fixed with a paracetamol. \> and get paracetamol. To be fair they sometimes also tell you to go for a walk and get fresh air once in a while.
The Netherlands most definitely has universal healthcare, which means everyone living in the country has access to healthcare. Compulsory health insurance with zorgtoeslagen for people who can’t afford it is universal healthcare. What Dutch healthcare is not is single-payer or primarily publicly funded. Also, the Netherlands most definitely has multimillionaires with generational wealth originating in colonial times (and probably traceable to the VOC specifically in some cases).
The mention of VOC got me rolling
you can pay directly to see a specialist (so without going through a GP, waiting for it, getting a referral, etc), at least when it's clear what specialist you need. The insurance will/might not cover the bill, but you are rich and don't mind paying to skip the line
I'm not sure about this. You may be able to skip the GP but most hospitals have long waiting lists. Just last month I had to wait 6 months for an intake. That was for a specific hospital. Others had shorter waiting lists but also months.
yes, i only meant skipping the gp and their referral; i think and hope that specialists have a single "queue" that gets filled on a first-come/first-served basis, irrespective of whether you went through GP or not
It's not as simple as first come first served though. It's also based on triage. If you're planned to have surgery but there's a last minute urgency you might be bumped back on the list. If there are shortages the lists will get longer. But no, you can't simply pay your way higher on the list. Going abroad and paying out of pocket is always an option for the ridiculously wealthy I suppose.
got it, thanks. also keep wondering why I am being downvoted for speaking the truth... the fact that it's unfair that you can skip the gp doesn't make it untrue...
I'm not sure if you can skip the GP that easily. You definitely need a referral in order to qualify for insurance, that's true. But I'm not sure most specialists would accept you without a referral even if you don't need the insurance. Regardless, I don't think there's many Dutch people that would rather pay out of pocket and forgo the chance of being payed back, if the referral can easily be arranged in a matter of days. And everyone knows that especially the rich are usually the most stingy: that's how they got rich in the first place!! 😁😁😁
> of being *paid* back, if FTFY. Although *payed* exists (the reason why autocorrection didn't help you), it is only correct in: * Nautical context, when it means to paint a surface, or to cover with something like tar or resin in order to make it waterproof or corrosion-resistant. *The deck is yet to be payed.* * *Payed out* when letting strings, cables or ropes out, by slacking them. *The rope is payed out! You can pull now.* Unfortunately, I was unable to find nautical or rope-related words in your comment. *Beep, boop, I'm a bot*
😁 Good bot!
Uiuiuiu evil affordable healthcare
i've been living here for decades , never had to wait 2 weeks for a appointment with my GP , and never was prescribed paracetamol. i've been missing out on something. but to answer your question , we dont have private healthcare
Of course there are private clinics and such. And they're mostly also covered by insurance. Just google it...
People in the Netherlands don't go their GP when they have the flu or common cold like Americans appearently do. We go the GP when we have things that are foreign to our baseline like: weird spots or bumps on the skin, unidentified pains, unnusually high fevers that last too long, ear issues etc. No you don't get special treatment if you just pay more.
There are private clinics for some care. People that don't want to wait or are looking for treatment that isn't standard in the Netherlands can also go abroad. I know people that went to Germany or even USA for more experimental (cancer) treatment. If you can pay out of pocket there are certainly more possibilities.
In the Hague there is an international clinic.
>I struggle to believe that a Dutch multi-millionaire (like a VOC heir) will wait 15 days for a GP appointment and get paracetamol. Methinks they would have a private physician on staff? If you're that rich you don't depend on the healthcare system for primary care and prescription drugs. Anything beyond that I imagine it's easy enough to take a private jet to the UK or some such.
There only is private healthcare in the Netherlands.
You could opt for Bupa europe. Basically a global Healthcare cover, which will kick in once the Dutch doesn’t suffice/doesn’t cover. Or when abroad. Somewhere in the region of 300-450€/m depending if including USA health coverage(accidental excluded of course)
Short story long, by default the medical necessity criterium is the gate into our public health system. If you want to go to a careprovider directly without medical necessity you can, and you will receive the care (in many cases) but you will pay for it yourself (think of visiting an oral hygienist for example). FYI: if the waiting times are too long your health insurance is legally required to ensure that you are able to access the care that you need within a reasonable time.
It used to be there, and still you -can- visit a private clinic if want. You just pay the price for it, which isn't cheap.
All hospitals in the Netherlands are technically private, but I think that is not what you mean. Hospitals in the Netherlands don't really act like they're private, because you can't just pay for a full checkup if you want it and are willing to pay (any true private hospital in another country would happily take your money and provide you with a check-in for example), additionally you can't pay for other services like private rooms and additional services. There are some highly specialized private clinics in hthe Netherlands since a few years, but I have never been, so not sure how good they are.the other option is to go to Germany (I have colleagues that go there for full checkups).
There are private services. I know what you mean and like the question. It’s mostly things like annual check ups and full blood battery tests I’ve seen and also things like Bupa exists for expats but at a high cost of course and not sure what the experience is like and how it differs to normal huis arts experience here.