PHM-Exch> World Cup of Health: The Netherlands vs. Spain

[Todd Jailer]

from the Hesperian blog:

World Cup of Health: The Netherlands vs. Spain

[image: Clip_image002]<http://hesperian.typepad.com/.a/6a00d83453cbad69e20134855483ee970c-pi>At
Hesperian, as with much of the world, football fever is in the air as
the
final of the World Cup approaches. Isolated whoops of victory and cries of
defeat can be heard around the office, as staff members surreptitiously (or
not-so-surreptitiously) keep an eye on their favorite teams. Comparisons and
discussions are inevitable, and it didn’t take long to connect the game with
the subject that is constantly on our minds here: health. What if the fates
of the two competitors in Sunday’s final were to be decided through their
approach to health and social justice, as opposed to a lucky kick of a ball?


Given the similar nature of the two countries, comparing their health
systems would at first appear to be a yawn-inducing draw. Both the
Netherlands and Spain have universal health care for their citizens; both
are in Western Europe; and both are members of the European Union. Here in
the US, where universal access to quality care is still a frustratingly
distant goal, we wish we had anything like our finalists. But even with such
enlightened rivals, quality health and especially health care equality is
not assured.

The Netherlands uses a dual-insurance system of national health care, with
long-term treatment and high-cost items such as wheelchairs covered by the
state, and shorter-term procedures covered by mandatory private insurance,
which is paid for by the individual and her or his employer. Spain, on the
other hand, has a national health service that is all-inclusive and can be
used by all residents. It is important to note that neither nation covers
the important fields of dentistry and eye care. In both countries, citizens
must buy private insurance for these.

Perhaps the biggest distinction between the health care in these two
countries is how they treat undocumented immigrants. This is one of the many
gaping holes in the recent US health reform, with the nation’s 7 million
undocumented immigrants living in third-world conditions because of a lack
of basic care. It seems that the Netherlands is not much
different<http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1173198/>.
Although they possess a wide social safety net, the Dutch do not extend it
all the way down the social ladder. Undocumented immigrants do have
opportunities to get care, but are often discouraged by doctors, the medical
system, and other factors. Spain, in contrast, passed a law in 2002
extending full medical coverage to undocumented
immigrants<http://eurpub.oxfordjournals.org/cgi/content/full/ckl266v1>and
there is little detectable difference between their access to care and
that of the average Spanish citizen.

When the teams line up for the final this Sunday, there’s no telling who
will come out the victor. In terms of equality in health care, however, the
answer is clear: ¡VIVA ESPAÑA!


-- 
Todd Jailer, senior editor
Hesperian Foundation
1919 Addison St. #304
Berkeley CA USA 94704
www.hesperian.org
Health for All, Now!
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