Is that where we’re headed? I’m not talking about that ritual which occurs as two friends fight for the check at dinner. And though my office is a block from Oakland’s “Oaksterdam University” , where there are classes on how to grow better marijuana, I’m not talking about those Amsterdam coffeeshops…….
And I’m not talking about their “Supperclub”, where you can eat on loungey white pillows while half naked servers swing from ropes and trapeezes to serve you while you listen to deafening music and watch videos that were appropriate for San Francisco’s 1967 “Summer of Love”…..
No, I’m talking about the Dutch healthcare system.
I was in Amsterdam about a week ago, bookending my Croatia trip.
The Dutch look quite healthy, bicycling by the canals. What’s up with their healthcare system?
For starters, there is no public option there. Instead, everyone is required to obtain insurance offered by private insurers. There are income based subsidies. Jonathan Cohn notes that 2/3 of the population get some assistance.
In his article in The New Republic, Cohn analyzes the Dutch approach.
What appears to be working in the Dutch system (which was revised in 2006) is that insurance is made available to everyone. There are no exclusions for pre-existing conditions. Cherry picking young and healthy subscribers is not allowed. Plans are audited. Those with a high proportion of unhealthy members get subsidies while those with a high number of healthy young adults get dinged with fees. Cohn notes that it’s a “risk equalization scheme”.
Insurers can’t charge higher premiums for older folks or for those who have riskier jobs or lifestyles.
Insurers are heavily regulated. There is a high degree of transparency.
Information about insurers and medical providers is made readily available.
There are aspects that might be politically unpalatable here, though. Cohn says the Dutch government is involved in setting prices (sounds like Medicare?) And the government defines the medically necessary services to be provided (sounds like Medicare?).
Cohn notes that the “public option” appears to be on life support.
Senate Majority leader Harry Reid was quoted today as claiming that a public option will be in the final bill, so perhaps the Democratic leadership is prepared to risk parliamentary tricks to get a bill.
But if there is no public option? Many progressives and activists on the left believe that without a public option, healthcare reform will be worthless. Some labor unions may be ready to abandon support for any plan that does not have a public option. Columnists wonder why democrats are so timid in defending the public option:
http://www.realclearpolitics.com/articl … 98532.html
Cohn’s article is a reminder to progressives that there may be other ways to promote a better system.
It’s a reminder to progressives that they need to be considering a Plan B. What works in other countries, and how to adapt it to what we have here?
Category: Political developments