An American Couple in Delft
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Dutch Health Care

One can’t live in a place forever without, at some point, having to become involved in the health care system. Lynn and I are now Dutch health care veterans. When we first got here we became enrolled in an insurance plan. There are private plans, which we are in, paid for by totally the employer at a rate less than what an American might pay as his contribution, not counting what the employer pays. There are also government programs. The best I can tell with my limited view is that the private plans give you more coverage and the cost, at least to an American eye, is very reasonable to the employer and zero to the participant.

I take two prescription meds. When I ran out of the first, I called the huisarts, the doctor, and he called the pharmacy. I was told to pick up the stuff that afternoon. I went in, they handed it to me and said thanks. No cost, no forms (other than showing my insurance card), no hassle.

The second one wasn’t quite so simple. The American name of the med was unknown to the doctor when we first visited him in January but he said he’d look it up. Meanwhile, I had enough to last me until last week.

I wasn’t paying attention and ran out before I realized I had none left. I called the doc. He was away for Easter. I went to the pharmacy. They looked it up under the name I knew and found its equivalent. The insurance is supposed to cover it but because I didn’t have a prescription, the pharmacy said they wouldn’t. Never mind that she could even sell it to me without a prescription, but that’s a whole different subject. I was able to procure five pills for €6.40.

When I went back to the doc on Tuesday for my full prescription, they somehow still didn’t know what the Dutch version was but the woman told me they would look it up and I could pick up the stuff at 5PM at the pharmacy. At 5PM I went to the pharmacy where there was nothing for me. They called the doc who said he wanted me to come back with the container. First, the container is unreadable because I use one that’s several years old due to its small size. Second, the pharmacy already knew what the equivalent was so why didn’t they just tell him? Third, if the doc wanted me to come back, why didn’t he call me instead of waiting several more hours, causing me to make the unnecessary trip and then just catching the doc before he closed for the day? They knew something was missing but instead of doing something about it, they did nothing until I came up empty. They’re not great in some areas of customer service.

As an aside, the first time you get a prescription, they’re only supposed to give you ten pills, not a three months supply. That’s so the insurance company doesn’t pay for 90 if the stuff doesn’t agree with you, which is a good idea. They gave me the 90 anyway and before they realized I had insurance, they said it was €13.40. So for 90 pills it was €13.40 but for five it was €6.40. Eighteen times the number of pills for about two times the cost. Why does it seem that something is wrong there?

So all is now well with me and Lynn decided I had all the fun and it was her turn to get sick. She started coughing away and had two sleepless nights. The cough syrup she used the first day didn’t do much so I went back to the pharmacy for another kind. The pharmacist gave me another kind but showed me that it will expire at the end of this month, four weeks away. As such, she had to give it to me for free. Gallantly, I let her have her way without an argument.

Today was the third day of Lynn not being well and even though it’s Sunday, I thought it best for her to see the huisarts. I called his after-hours number and discovered that during off-hours, one goes to the huisarts post at the hospital. It’s a separate building on the hospital grounds that’s a regular doctor’s office and is apparently manned by one doctor on a rotating shift during off-hours. Lynn explained her symptoms and was given a prescription for antibiotics. We walked out and she said what I was thinking: there were no questions as to other meds she might take, there was no throat inspection nor anything one might expect a doctor to do in the U.S. The doctor did, though, listen to Lynn through a stethoscope.

When it was time to get the prescription filled I wasn’t sure what to do. In the Netherlands, one is assigned a pharmacy and I know ours is closed on Sunday. In fact they almost all are. But just like there’s one doc on call, there’s one pharmacy that’s open, or sort of open. I went there and found the door locked, scratched my head a few times, pulled on the handle again which was still locked, and as I thought about what to do, someone buzzed me in. I opened the door and that was as far as I could go. A wall had been lowered into the rest of the store and the pharmacist was behind something that resembled a ticket office window. Slide the prescription and insurance card under the glass, then they slide the stuff back out. Forget buying anything else in the drugstore because all the others are closed so that wouldn’t be fair. I should point out that a pharmacy is a pharmacy, not like CVS or Rite-Aid. They don’t sell shampoo, after-shave, bar soap, or anything else like that. That’s the area of a different kind of store like Kruidvat which sells no pharmaceuticals except low strength over-the-counter stuff.

Lynn is now on her way to recovery. Our general impression is that it’s cheaper to get sick here because insurance costs so much less and covers everything, but we don’t have the warm fuzzy that they are as thorough as (we think) they are in the U.S. about examining the patient to see if the patient’s description is accurate. Of course, we could be wrong, and I certainly hope we are wrong, but I really hope we never get to find out.

 

2008 Rick Wexler   last updated February 21, 2008