Patient takes Health insurance to court

The Daily herald writes today that the Court in First Instance of Bonaire, St. Eustatius and Saba has given Dutch Minister of Health, Welfare and Sports Edith Schippers eight weeks to take a new decision on a case in which the
Medical Insurance Office in Bonaire refused a client medical transport to the Netherlands. The insured, assisted by lawyer Ernst Wesselius, lodged an appeal against this decision.

At the end of February, the patient visited the local cardiologist because of heart complaints. The specialist diagnosed “new onset angina pectoris” and referred her on February 27 to the intervention cardiologist at the Amsterdam VU Medical Centre for heart catheterisation.

The doctors were of the opinion that the technical possibilities (intra-coronary physiology) and the psychological pressure on the patient were clear indications to undergo this medical examination in the Netherlands.

However, the request of specialists Dr. Kamp and Dr. Van der Zee for medical referral of the insured to a non-contracting care provider in the Netherlands was refused – on behalf of the minister – by the head of the Medical Insurance Office on the island.

In accordance with advice obtained, the reason for the refusal was insufficient medical arguments regarding content to justify transport to the Netherlands. “When taking her decision, the minister failed to reckon with the circumstance that the patient was to undergo this not entirely innocuous treatment with the possibility of a second operation in Colombia,” the lawyer argued during the session. “She experiences this as emotional pressure, due to her psychological panic disorder. None of this is mentioned in the contested decision, while it was most certainly pointed out as relevant for medical transport of the patient to the Netherlands,” Wesselius added.

The patient clarified during the court session that this psychological pressure was fostered by meanwhile 22 (very) bad medical experiences in the past year-and-a-half, with medical transports from Bonaire to Colombia, where patients must undergo treatment even if they cannot communicate with the doctors in attendance there due to the language barrier.