Over here in the Netherlands, we used to have a single, state owned health insurance policy, which had really good coverage for any nescessary medical treatment. You could pay a bit extra to get additional coverage for unnescessary treatments (like getting gold fillings at the dentist instead of ceramic fillings, or plastic surgery). Premies were very affordable, and there was a state subsidy for the lowest income classes.
Then about 25 years ago, the wave of neoliberalism hit Western Europe, and the mantra 'leave everything to the open market' took over all government policy.
This lead to our railways being privatized, our energy network being privatized, our water supplies being privatized, our postal and telecommunications services privatized, our education partially privatized, and ofcourse, healthcare insurance too. Because, fair competition on the market would lead to more efficiency and better prices.
The reverse happened. 25 years later, premies have almost doubled at the couple of dozen healthcare insurance companies that emerged and survived competition, in part because they all need to make seperate micro agreements with pharmaceutical companies and hospitals, foregoing bulk price drops, part because healthcare went from being a non-profit organisation to many organisations out on the stock market, with a need to make profit to please their shareholders.
On the bright side, the government subsidy for the lowest income classes is still there. It did not grow in proportion to the price increase though.
Ever since the privatisation, healthcare insurance CEOs used to earn more than our Prime minister, and some even do, despite a recent law forbidding them from earning more than a PM.
Parallel with this, basic insurance coverage has decreased. Some treatments that used to be in the government healthcare are no longer available unless you have a premium policy. A good example is (female) anticonception. Women have to pay for that themselves now. (Condoms never were covered by insurance to begin with. Men have less rights then women)
On top of that, government budget cuts implemented a personal risk fee of nearly 400 euros. Whatever your healthcare needs, the first 400 euros per year you'll have to pay for yourself. This has hit chronically ill hard, and studies show that lower income folks no longer go to a doctor, because they can't afford the 400 euros. There's subsidy for the insurance premies, but not for the personal risk fee. It's already leading to higher healthcare costs, for having to treat illnesses at a late stage, which would have been cheap to cure when diagnosed in time. This in turn leads to even higher insurance premies, because the insurance companies have to compensate for the higher healthcare costs.
For the average consumer, finding the right insurance has become an untransparant maze. The most recent development is that insurance companies are allowed to negotiate with single hospitals / aid providers every year. People have been surprised to find out that for certain treatments, they can no longer go to their own hospital, because the insurance company they're with did not renew their deal with that particular hospital this year. Or their autistic kid can no longer see his personal trainer that has accompanied him for years, because no more deal this year. Sometimes people have to travel halfway across the country to find insured care.
So, while usually I am still rather lyrical about how good access to healthcare is over here (it still is excellent compared to most other countries in the world), it's not as good as it used to be.
(The good news is that we'll have elections soon, and a majority of the political parties has already said they want to get rid of the personal risk fee altogether. Even one of our current governing parties has said so. I think the odds are good that it will indeed go away)
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Topic: Your national healthcare system (Read 8398 times)