Hein (fub) wrote,

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Class healthcare, and how Henk van Gerven proves himself an idiot

A hospital in Amsterdam has come under management of an investor, making it the first hospital in the Netherlands in private hands. The new management has decided to diversify its offerings, by giving more luxury to 'customers' who pay more: single-bed rooms, choice of food, internet, etcetera.
In the article I linked to, the author uses the word 'klassenzorg'. "Class healthcare", analogous to "class justice" -- a term with a very negative tone.

Henk van Gerven, a member of parliament for the (ex-)Maoist Socialistische Partij, proves himself to be an idiot by loudly proclaiming that first class healthcare also means there is second class healthcare -- something our egalitarian revolutionist brothers can't tolerate!

One of the ideas behind nationalised healthcare is that the broadest shoulders carry the heaviest load. This means that people with a higher salary actually pay more healthcare premiums than people with lower/no salaries. Premiums for health insurance are coupled to your income, not to how much healthcare you actually need/use. In 2004, about 12.3% of the GNP was used for healthcare -- it is a substantial part of our economy, and most of it is financed via taxes and (nationalised) health insurance premiums. In the last few years, the costs of healthcare have not risen as fast as the GNP, so the percentage these days will be a bit lower than in 2004, but that doesn't mean it's anything to sneeze at.

What could be better than to get people with more resources to pay more, so that healthcare becomes less dependant from the premiums? Offering patients access to internet or a choice of food does not cost much and does not interfere with the quality of the healthcare for other patients. But it does generate funds that can be used to improve the hospital -- something all patients will benefit from.
Sure, "first class" means there is "second class". But if "second class" is actually the level of healthcare we can expect today, "first class" means an improvement. Surely we should applaud advances in healthcare, especially if these are paid for by the richest people?

Also, if you allow hospitals to make money, it means there is an incentive to be more efficient with resources. If, for instance, a hospital can find a way to do more operations per year in the same operating rooms, that means an overall improvement of healthcare -- shorter waiting lists, more people being helped with less money. Or suppose the hospital offers non-essential healthcare for people who pay for it on their own dime -- people who want that healthcare and can pay for it, can get it, where they previously could not. Their money gets fed back into the system, meaning an increase in funds available for healthcare in total.

Someone has to earn a living streamlining these processes, to give them an incentive to do so. Enterpreneurs have a keen sense of how to do that. Civil servants do not. Right now most hospitals are run by a bureaucratic organisation, with the accompanying costs. Change is slow and costly as well -- all those costs could be used to improve healthcare with some improved efficiency.

When carefully executed, "first class healthcare" may actually be a blessing for our nationalised healthcare system. With more and more people growing more and more older and needing more and more healthcare (in 2003, more than half of the costs of healthcare were used to care for people older than 65), and with less and less young people to pay the premiums, we need to do something to revitalise the healthcare system.

However, I strongly suspect our revolutionary friends from the SP won't be happy until all wealth is taxed away, and we all live on a modal income, being 'served' by one monolithical bureaucracy consisting of dis-interested drones. Russia experimented with that for some seventy-odd years, and they didn't like it in the end.

I never quite get used to the fact that my fellow citizens elect idiots like that into parliament.

(As a curious side note: it turns out that the manager of the hospital in question still has to perform a substatial amount of community service because of an earlier conviction for fraud.)
Tags: politics

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