An Expat's View of Dutch Health Care

First of all, yes…it has been very hot here. One day it was over 100°F. Luckily we have air conditioning in three rooms (and Alex’s room is nicely shaded on the ground floor), so we’ve mostly been fine, although the air conditioners have been earning their keep over the past week. Thankfully we’re back down to highs around 75°F now, so everyone, including the electric bill, is much happier.

It has been a while since I’ve talked about the Dutch medical system. We recently had another experience that I thought you all might find interesting, so here’s a quick overview.

Some of you know that we’re going to Botswana in mid-July. About a month before our departure, I received the usual “here’s what to pack” email. Buried in the list was a recommendation that we get preventative malaria medication. Fair enough.

As soon as I saw that, I emailed my Dutch doctor asking whether she could prescribe it and, if so, whether I needed an appointment. The doctor’s office responded the very next day, which was shocking since it usually takes about five days, and told me that we needed an appointment with the one doctor in the practice who handles travel medicine. So far, so good.

The next morning Mike called during the official “appointment request hours”. (Yes, there is a designated two-hour window when appointments may be requested. Do NOT try to get an appointment outside of these hours. It will not be permitted.) He asked to schedule appointments for all three of us.

Oh no!

The travel medicine doctor had left town that very day and wouldn’t be back for a month. (This feels very Dutch. People here disappear for a month in the summer without anyone batting an eye.)

But wait! There was a solution.

The receptionist explained that we didn’t actually need an appointment. Instead, there’s an online form you fill out, and the doctor prescribes the medication based on that.

Excellent!

Except…the form has to be submitted at least 28 days before departure, and Mike happened to call on day 27.

Therefore…they could not help us.

The most frustrating part is that the original email could have simply said:

1. The travel medicine doctor will be gone for a month.

2. You don’t actually need an appointment, you need to fill out this online form.

3. Oh, and by the way, the form has to be submitted at least 28 days before you leave.

Had they mentioned the form in the first place, I would have filled it out immediately and everything would have been fine.

This is one of the things I’ve found most challenging as an expat. There are often very specific rules for how things are done, but nobody tells you what those rules are until you’ve accidentally broken one. Then everyone looks at you sympathetically while explaining why nothing can be done.

Never fear, dear reader. There are private travel medicine clinics here, so I called one of them. They mailed us the medication, and we’re now fully supplied with the appropriate anti-malaria drugs.

Problem solved.

Still…it could have been so much simpler.

Not my actual house :-)

One other comment about Dutch health care. You may remember from previous posts that Dutch doctors are true gatekeepers of the medical system. If you want to be tested for something (flu, strep, a UTI, or almost anything else) the typical process looks something like this:

• Go to the doctor.

• The doctor tells you to wait two weeks, rest, drink plenty of fluids, and take Tylenol.

• If you’re still sick after two weeks, go back.

• Then they order a test.

• It takes a few days to get an appointment for the test.

• A few more days to get the results.

• Then you schedule another appointment to discuss the results with your doctor.

  
  

So from the start of an illness to actually discussing test results with your doctor is often four to six weeks.

Coming from the U.S. system, this feels wildly inefficient. If I thought I had strep in California, I could usually email my doctor in the morning, get tested that day, and know the answer by dinner.

I’ve asked several Dutch people whether they’re happy with this system. My question is usually something like:  “If you thought you had something that could be diagnosed with a simple test, and there was a way to get that answer within a couple of days instead of several weeks, would you prefer that?”

The overwhelming response (everyone except one Gen Z woman) has been:

“No. I’m happy with the system we have.”

I was genuinely surprised.

My guess is that this reflects a broader cultural value. The Dutch place a high value on an equitable health care system, and I think many people feel that if everyone waits four to six weeks, then that’s fair. It creates a very different mindset from what I experienced in the U.S.

That said, I haven’t lived in the U.S. medical system for a couple of years now. Maybe it’s changed. Maybe there are just as many hoops to jump through these days.

So I’m curious: how are things going across the pond? Has getting routine medical care become more complicated, or is it still relatively straightforward?