It’s an interesting comparison at the very least.
Especially between these two countries.
For the contrast couldn’t be bigger, it seems.
We have proper health care in The Netherlands. We do. It’s nearly unaffordable these days, but up to a certain point, people who fall ill, have the security of being cared for and it doesn’t cost them (too much).
The sights you see (in films and series like Breaking Bad, Good Girls etc) where people, upon arriving at the hospital, are handed out a form to fill out, is something that doesn’t happen here.
In order to achieve that, everyone who works, pays taxes and also a part of insurance for all the people in this country. If you have a better paying job, that means you pay more, as it’s a percentage of your wages. We are taught from a young age that paying taxes is a good thing to day. That our country and everyone in it, thrives on it. That you help people who are sick and needy, that it’s like giving to charity, in a way. Of course there’s still lots of (rich) people who still prefer to keep their money theirs, but there’s always exceptions to that rule.
Insurance companies here build plans. Until about a decade ago, the plans were devided between people who could actually afford care and people who could afford less. If you see that as seats in a plane, it was devided between ‘Economy Class’ and ‘Business Class’. In Economy Class you didn’t actually have a say where you were seated or how comfortable you were, but given that you didn’t have to pay that much, it made sense that someone else should make the decision (more) for you. Business Class was the opposite: you pay more, you had a say and at times even a choice of Care.
As I said, about a decade ago, this changed. We all became Economy Class people. It is now illegal to not have insurance. It is now no longer possible to have a choice between things needed in Care, you only have a choice in amounts of money to pay. Which is:
-A Very Big Lot, or
-An Insane Mountain of Money
Automatically you pay the first if you don’t have (much) money. You pay the latter if you’re chronically ill and can’t bare life without medical assistance. It is usually hard for these people to find an insurance company. They have to find one that ‘accepts’ them, the medications they’re taking, the therapists they like and need and so on.
Also, the insurance companies have a huge influence on medical supplies. The idea was to persuade doctors to prescribe medication that was less expensive, so that pharmaceutical companies would be forced to kneel down and demand lower prices for their meds. It now has come down to insurance companies having so much power that no human being has a right to any Care, unless they can proof they’re not lying and really need it. This also means giving up a lot of privacy. Even the privacy one would expect at their doctors’ office.
You see, in order to get a prescription, you need your doctor to write down what it’s for. The dosages are restricted to certain diseases, illnesses and this also includes mental illnesses. So unless a doctor declares on a form what the meds are for, you won’t get the right amount, And yes, the insurance companies really are that strict.
Then there’s pharmacists. Pharmacists have actually studied medicins (along with doctors) and know the chemical base of the patient. They know what medicins can and can’t be combined, something that a doctor doesn’t always know. S/he is your GP, not the one you see for absolutely everything. So, sure, if you’re a diabetic, s/he’ll know more or less what meds you take, but not necessarily if it will or won’t effect other meds you’re taking. When there’s other doctors involved, that’s even trickier. That’s where a pharmacist comes in.
Then there’s insurance companies. Who are just part of this Health Care System.
They’re (sort of) willing to pay you (some) of the money you have to pay in order to get well again. The problem is: they see you as guilty of lying. They do not believe you actually NEED these meds/therapies/medical supplies until you proof that you DO. And everything that’s not in your health plan, you need to pay for yourself. This even includes (nowadays, it didn’t used to) the instructions pharmacists’ assistants give you when you go there to pick up your medications. Which makes people furious at these assistants for even trying to explain.
I have studied to become a pharmacist’s assistant, and this was the main reason not to go through with it. Insurance companies are such vile bastards, they need human boxing balls for the patients who become more angry for not actually getting any meds for ‘free’ (they already pay quite a lot) for medications they need. As a pharmacists’s assistant, that’s who you are. A boxing ball. I was instructed to tell patients why they had to pay for their meds. There was no real reason, it’s just that the insurance companies don’t want to loose that much money. I’ve had colleagues who had their faces scratched, being spat on, kicked in the shins and all that, because the assistant would tell them they now had to pay for even the instructions of their meds, thanks to the insurances.
And insurance companies don’t listen to doctors. I’ve had a mother in law with cancer. For her treatment, she had discussed with her oncologist (chosen by herself, approved by her insurance company) how to take her pills, a chemo.
She wanted to take 10 pills each day, for 10 days, so that she could feel like bloody shit for a relatively short period, then three weeks of feeling quite OK.
The other option was to take a pill each day and feel relatively shit the entire year.
That sounds like an option one should have, no? To take pills in the order that you want. If you have your doctor’s approval?
Not for the insurance company. They told her that if she wanted to take her pills that way, there was a certain bonus of 50 euros she wouldn’t receive.
It’s a mild amount of money, I am aware. But the guts this insurance bastards have, to tell a terminally ill patient how s/he can/has to take their meds! Sometimes I hear prisoners complain about inhumane behaviour. I think insurance companies here are going that same direction. Who the f*** are they to tell patients of doctors who have been verified, accepted and acknowledged, to tell that they want the treatment to go elseways, or otherwise you won’t get money?
I do understand why something like crowdfunding is a thing in the USA. Insurance is completely unaffordable if you’re only one of the few who actually pays taxes and so on.
If you don’t have insurance, it’s pretty much the only way to go. That or suing a company who you believe is responsible for the lack of health in your life.
The thing with crowdfunding is, people can decide whether or not you are cute enough, have a point in not getting treatment for free or affordable prices yet. But it’s a tricky business, as you give up all the privacy you have.
After all, you’re gonna have to show people you don’t know, exactly how sick you are. Your name, your family, your neighbours etc: everyone will know who you are. People will see to it that their money is well spended. You are being watched. You’re an investment of sorts.
And people don’t want to save just anyone. If you have had an unhealthy lifestyle, or people don’t like your race, your gender, your religion or the place you’re coming from, they get to tell you: no, you had it coming, you’re not worth saving.
They simply will not give you any money.
With insurance companies, you don’t have that ‘convincing’ part of others, who simply have no other choice than pay taxes etc. You have to convince the insurance company you’re not a fraud, yes, but other than that: it doesn’t matter who the hell you are, if you fall ill, things will be taken care of. They don’t have your face with it, nobody wil recognise you in the streets.
So, when I hear someone say: ‘the government should meddle less in people’s health care’, I think: people should care more about each other. And for real. You shouldn’t care about whomever receives the care that you are paying for by paying taxes. It shouldn’t be necessary that Breaking Bad is a true possible scenario. I can’t watch that series as it’s so unreal to me on specifically that level (OK and I hate both the wife and the sister, but that’s quite a different story).
How many lives could be saved in the USA alone by being insured for proper health care? And it’s not ‘meddling’ if you’re making sure that someone gets better. If you put it like that, no-one wants to have health care, indeed. A government should care for its people and not withdraw their responsibility. Because that’s factually it. It’s not ‘less meddling’, it’s less caring. It is saying: I take my hands off my responsibility for you. Given that it’s Trump, who doesn’t care about anybody but himself, I do get where he comes from. But the rest of the USA? I don’t get that. Obama had a proper plan, and people are still shooting at it. For heavens’ sake why?
Less meddling is what our insurance companies could use. Shut the f*** up about people’s plan of health. If you accept a doctor to your health plan, then indeed accept their plans of caring and don’t tell their patients that eventually you’re not gonna cough up the money.
But that’s The Netherlands for you. It works so well here, we get to complain about how it doesn’t work in other scenarios. Meanwhile, we all pay, the CrowdFunding is barely ever used for Care supplies. Only when meds are very rare and therefore, very expensive.