JONATHAN COHN NOVEMBER 3, 2011
Critics of health care reform frequently warn that it will reduce the quality of medical care in this country, by stifling innovation and handing more control over to government bureaucrats. And to back up their case they like to cite the state of health care in Europe, which is supposedly inferior. But that argument really isn’t very persuasive – and a big reason is the state of primary health care here and abroad. The Netherlands is a prime example, as I discuss in the latest of my dispatches for the Commonwealth Fund, which underwrote my research and travel there:
In the Commonwealth Fund survey, 59 percent of respondents from the Netherlands reported getting recommended services for diabetes, second only to the United Kingdom (where the response was 67 percent). In the U.S., just 43 percent of respondents reported getting the recommended services. In addition, patients in the Netherlands were least likely among the eight populations surveyed to experience care coordination problems, such as duplicate tests or physicians not having records at time of a consultation. Just 14 percent of Dutch respondents said they'd had such experiences, compared with 34 percent of Americans. The Dutch are way ahead of Americans—not to mention most other countries—when it comes to the integration of information technology into medical practice. Surveys show that virtually every Dutch physician now uses electronic medical records, although coordination between doctors and hospitals remains a work-in-progress.
The cultural differences between our two countries are vast. Even if the Affordable Care Act called for creating a health care system that looks exactly like Dutch, our systems would end up looking pretty different. As I note in my brief, the Netherlands has a long tradition of strong primary care.
Still, critics who think Europe’s experience proves that reform will backfire here need to look a lot harder. Other countries have important lessons to teach us, but it’s not the ones you tend to hear about in the political debate.
By the way, if you missed my first Commonwealth dispatch, also from the Netherlands, it’s here.