At the end of the year, people in the Netherlands are able to switch from a different private health care insurer. We basically are able to choose from basic, legally determined packages and topping these with additional health care plans (which contain issues uninsured by the basis package). Below, I give you my opinion about this choice.

Two weeks ago when introduced to new collegues, I managed to blurb out that I had trouble with the current Dutch healthcare system. The immediate response was that we choose our cell phone plans, so why not our healthcare plans. I was baffled for a second, but then realized that healthcare and cellphones are separate issues. One, I control the amount of time I spent on my cell phone and so can determine which plan is most suited for me. Two, I don’t control my health to the ultimate degree. I can break a leg, can get into an accident without it being my mistake and I can get a lethal disease. I cannot oversee how much it will cost to fix all this. I can perhaps calculate what the chances are, but from an individual point of view if there is a chance, you would want to make sure you are able to pay for your health care costs when it happens.

The current health care system developed from the idea that markets are efficient. Markets will push hospitals and health care insurers to be cost efficient. The more a consumer has the option to choose, the more competition there will be to complete this.

I basically think that this is a fallacy. When I’m sick, I’m not a consumer. I’m a human being that needs a doctor. Yes, that still places me in the center of attention, like a consumer hopes to be (consumer is king) with a doctor who wishes to cure me. But when I’m a human being I do not want a doctor that wants to get me out of the hospital as quickly as possible or else I will be too costly.

Also, individuals are not able to oversee whether they should insure something. And whether they should insure 6 or 10 visits to a physiotherapist. On a reasonable basis, no individual is able to make a good choice.  This only leads to more stress and most people do not even compare health care plans every year when they are able to switch. They will stick to the same one. Even though, terms and conditions change every year. This choice is not an enrichment.

Thirdly, the larger the population the better an insurer is able to calculate what the chances are of a disease or accident happening. The more split these diseases, the less a population will be predictable. And the less predictable the less realistic the premium is one will have to pay.

I honestly would reconsider national health care. Sure, nations like France and Sweden have problems with their systems. But I think there is a midway between bureaucratic state control and market control. Hospitals could be rewarded for a combination of best quality and cost efficiency. A system where hospitals and doctors compete for quality and not money. I think that would be in the best interest of our health.