Conversation in Amsterdam about privatization (transport and health)

[LeftishBrit]

I was in Amsterdam last week for a conference. I went by Eurostar from London to Brussels and that all worked like clockwork. Then I took the connecting train to Amsterdam, and that was very messy: there were engineering works that we hadn't been warned about; we had to change trains, and there were no clear instructions as to exactly where we would need to change again; generally pretty chaotic. A Dutch passenger informed me that this sort of problem with the trains had not happened until the current government decided to privatize the transport system. Since then, chaos has apparently been the order of the day. She went on to say spontaneously that health care has also been much more chaotic since partial privatization of the system (note that even with this relative privatization, there is *still* some public option); but added that 'I have just been to America, and it is so much worse there!'

[Cant trust em]

1. Were the problems still in Belgium, or had you entered the Netherlands yet?

I had train trouble in Belgium, so I wonder if they're just not on top of it.

[LeftishBrit]

2. We were in the Netherlands by that point.

It was my first time on that train, so have little relevant personal experience - just quoting what the Dutch woman said.

[kenny blankenship]

3. That touches on an important point re: Netherlands HC- the current system is all of THREE yrs old

From the 70s to the 2000s Dutch healthcare was completely regulated by the state. Covered everybody. Three years ago they moved to partially privatize it. And the plan was for it to go completely private over time. Dutch healthcare has a good reputation based on the preceding decades of "socialist medicine". When people tell you we don't need no public option or gummint healthcare meddlin'-- just look at the Dutch they have everyone covered and it's a private insurance system REMEMBER THESE THREE THINGS.

A. Two Thirds of Dutch households are receiving STATE SUBSIDIES to cover their private health insurance. Nobody is talking about anything like that level of subsidization in the present "reform" debate in Washington.

B. This newly privatized system is not the one that gave Holland its reputation for excellent egalitarian health care. How could it be- it's no more than three years old! Meanwhile over 40% of the Dutch populace thinks it's headed in the wrong direction. Which is not surprising since the plan came from American think tanks. The plan called for complete deregulation over time, but consolidation in the insurance sector there since the plan was proposed has alerted the Dutch to the danger they've put themselves in. That plan is likely to be halted and changed.

C. Like Switzerland, which is the other example of a "private" system with individual insurance mandates that free market swindlers say we can follow, the Netherlands has low low rate of poverty compared to the United States. The rate of poverty is important because it serves as a general yardstick for how a society tolerates inequality and exploitation. Both Switzerland and the Netherlands are like small, middle class bedroom communities of Western Europe. In the Netherlands the government redistributes wealth openly by means of subsidies like the insurance subsidy. There are others for housing, etc. Consequently the rate of poverty in the Netherlands and Switzerland runs typically at ONE THIRD that of the United States. The point being that you can't really compare America on one hand and Switzerland and the Netherlands on the other and say what works for Switzerland and the Netherlands will work equally well in America. We have COMPLETELY different socio-economic systems. Inequality and exploitation are American fixtures, so much so that many in the middle classes here think they are forces of nature like gravity, unaware that it is different in other places. In those two tiny European countries they would not allow a privatized system to fuck over the working poor. In America you KNOW we would, because we already do. My theory is that the antiquity and small size of these 2 countries forces the wealthy to live with the poor. The very rich can move away to gated estates but the upper middle classes simply don't have anywhere else to go to get away from their poorer classes. In America there's always been open range for wealthier classes to flee to, and so they do. And not just the rich but the middle classes too. Consequently they don't feel a sense of kinship or common nationality with working poor in rural or urban areas, and the policies of our political parties reflect that. A Detroit or New Orleans or Baltimore disaster area where a major city is abandoned and left to collapse with all the poorer people stuck inside it just would not be allowed to happen in Netherlands or Switzerland. Wealthy people over there literally VOTE TO GIVE THEIR MONEY AWAY not to have to look at the squalor of poverty. So in the Netherlands, poorer people receive excellent health care FREE and the near poor are heavily subsidized. In Switzerland, it is against the law - AGAINST THE LAW ! - for private insurers to make a profit on the delivery of basic health care. They can only make money on supplemental insurance. We wouldn't even call that arrangement private enterprise or capitalism in this country. To give yet another measure of how different their situation is from the American situation, because of the non-profit nature of primary healthcare in Switzerland, 95% of Swiss people ALREADY had insurance at the time that the law was changed to make insurance mandatory. And yet people on this very site try to tell you that the Netherlands and Switzerland show that all we have to do is pass mandatory private insurance, like they're talking about in Washington now, for our healthcare problems to be fixed. THEY NEVER MENTION THESE THREE OTHER THINGS.