Posted by: AtlasMD

November 22, 2013

1 Comment

Food For Thought – Dutch Healthcare

It feels like the sky is perpetually falling on the American healthcare system. And yes, the first part of solving a problem is admitting you have one. But, we came across an NPR article discussing some things the Dutch do differently than we do. Really, it isn’t a question of whether one of us is doing it better than the other. Instead it’s that these differences could suggest our different value systems.

Take this quote, for example: “The Dutch like their health care system and feel comfortable with it, polls show, even when things don’t go exactly as they want.” This aligns with the Dutch’s values of pragmatism and stoicism.

In the Netherlands, many women try to have their babies at home. NPR claims that is because “[Dutch women] view giving birth as something that should be natural, not medical.” And services across the country align with this idea. In Amsterdam there’s a center for pregnant women that combines a spa, shopping center and school — not something we’ve heard of here in the States.

The article goes on to say, “The Dutch also feel strongly that death is something highly personal and that patients should be in control.” It turns out that the Netherlands passed legislation to legalize euthanasia. Now doctors can actually help patients die by administering a lethal dose of medication. There, it’s acceptable for people with painful conditions, such as cancer, to decide when they want to step out of it rather than prolong their medical treatment, he says. NPR claims, “Ultimately, the health care system ends up saving money.”

Now we aren’t in the position to say what’s right or wrong here. But as a nation we’ve accepted euthanasia to be an immoral stance. We see our values at stake here. So what do we value? Perseverance, hard work, discipline, etc. and persevering, hard-working people don’t give up even when the tough gets going.

Dutch culture emphasizes that dealing with life’s problems helps usher young people into adulthood. In keeping with this view, it is considered preferable to endure aches and pains without resorting to medication.”

This is completely contrary to an American attitude. In fact, it’s not a pleasant topic, but studies show that painkiller abuse is a serious problem. However, here at Atlas MD, we’re blessed to have a personal relationship with our patients. We get to spend time with them, and find out what’s going on with their lives. Of course, we’re not psychiatrists. But we are given an opportunity to make a call on whether a patient might potentially be abusing barbiturates prescribed for, say, a severe back problem.

A Dutch sociologist says, “‘Most pains will go away by themselves’ is the philosophy [in the Netherlands]… If patients are given medication, doctors are careful to prescribe the minimum amount for the minimum time.”

And get this, the Netherlands spends less than half of what we do on medications per person. There’s a value that might be similar there, though – savings. Americans love saving money (Black Friday, anyone?). But what if by spending a bit more time with their doctors, patients weren’t prescribed unnecessary prescriptions? This could equal a lot of money saved. Especially as more patients migrate to the cash-only model.

Here’s a new way to look at healthcare, a new way to value the experience: Success should be making people better with the least amount of intervention. Everyone should have skin in the game so to speak – patients and doctors – so that we can move healthcare away from this current price-convolution, where no one really knows what costs what, patients with insurance “win” by buying more meds and meeting deductibles, doctors win by prescribing more pills and getting kickbacks from drug companies, and people without insurance can find themselves going bankrupt after one prolonged hospital stay.

Yes, there’s a lot to change. But until we address what we value as a nation, we might just be squabbling, not truly changing anything.

One thought on “Food For Thought – Dutch Healthcare

  1. Pingback: Here’s some food for healthcare thought — Dutch o… « Hippocrates Shrugged

Leave a Reply

Your email address will not be published. Required fields are marked *