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by jillesvangurp 1309 days ago
I have great respect for what people like you do. I've lived all over Europe and a have some first hand experience with care in different countries. Universally, nurses are heroes and it's just a very hard and often thankless job. Not to mention under paid in many places. But there's a big difference in what I would label as institutional stupidity between different countries. Some countries feature a lot of mismanaged health care facilities where things are bureaucratic, slow, etc. For example, Germany is hopeless on this front. Being in the health care system here means an endless sequence of forms that need to be filled in with the exact same data points over and over again and over worked nurses dealing with all that crap on top of their normal job. It's beyond stupid. Nobody shares any data. And it's inefficient and dangerous for patients because no doctor or nurse can possibly have the full picture.

My home country the Netherlands is very different. My father had a stroke quite recently and spent some time in a very modern hospital where they are applying some of the latest insights for patient care. So, he was obviously hooked up to lots of equipment and intensely monitored. However, this hospital has separate rooms for all patients. Reason: it's best for the patients and helps them recover more quickly. Basically, more privacy for the patients and less restless nights. There are no TVs in these rooms. Instead patients are issued ipads with entertainment options and access to various things like indicating dietary preferences. Nurses carry ipads as well. Everything is digital. There are no paper charts in sight anywhere.

The rooms were modern, clean, and clearly optimized for making patient handling easy and straightforward. What struck me was the attention to detail and level of pragmatism in this. For example, my father's room had wall mounted hangers for folding chairs. These are for visitors. And when they are folded they are not in the way. The room had a whiteboard and a locked cabinet for medication and supplies. The doors are sliding. So, it's easy to move things in and out. Like beds, wheel chairs, equipment, trolleys. Etc. And so on. Just a really well designed and thought through design and architecture. Well managed and efficient.

BTW. This is not a private hospital: my country has a mandatory private insurance system: they can't reject people, people must be insured, and they can switch insurer. So, insurers mainly compete on quality care. Miserable patients and inefficient hospitals are bad for business and they are working to fix any issues there with hospitals. Which is why everyone, rich or poor, gets the same quality treatment in this hospital. It's way better than the private insurance I pay for in Germany. Way cheaper too. My German insurance is about 5x the price. I've been in a hospital here a few times and they can learn a thing or two about efficiency there.

1 comments

The only bad thing about Dutch healthcare is that, if you are not acutely in need, it can take months to get a spot.
I have heard similar complaints about UK and Canada. From a cost perspective, it makes sense to me. I also wonder: If you make people wait months, how many people skip/cancel the appointment? Probably many.

I have lived in two countries with very unfair healthcare systems. High income people get "health insurance" (whatever that term really means!) from their employer. They use it a LOT. Way too much. And their "health insurance" covers most of the cost. The number of times that I have seen high income people see a medical doctor for a runny nose (light head cold) stuns me. What an incredible waste of medical resources! As someone fortunate enough to have this "health insurance" at various times in my life, I am constantly saying "no" when doctors try to over-prescribe all manner of medicines. Obviously, they know my insurance will pay 100%!

The #1 duty of a public healthcare system absolutely must be "acute need". Everything else is second priority, else they go bankrupt. It's rough. I don't know a better solution.

Crazy idea: What if there was a kind of public auction system where people in the queue could set a price to sell their position? As long as it was fair and transparent, I might be OK with it.

I'd say that's universal across many countries. The flip side is that Dutch insurers do allow their patients to shop around for care. E.g. getting treated in Belgium or Germany for routine procedures is fairly common. Mostly these just are shortages of staff, equipment, etc. and being efficient sometimes also means that available care is fully utilized. Which just means people have to wait for non critical things sometimes.