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In their Editorial, The Daily herald writes today, that the Second Chamber of the Dutch Parliament member Ronald van Raak has taken a position that – for a change – truly seems in the best interest of the islands (see related article). His Socialist Party (SP) in cooperation with the Saba Labour Party (SLP) is questioning the intended trimming of the health insurance package for the Caribbean Netherlands per January 1, 2015.
While measures to save US $1.5 million annually already were postponed for a year and the current plan is actually the result of a counterproposal from the public entities Bonaire, St. Eustatius and Saba (the BES islands), reportedly having insured patients pay for a number of physical therapist sessions just isn’t a very good idea.
One can argue that this is also the case in the European part of the Netherlands, but the circumstances are quite different. Partly due to the switch from the Antillean guilder to the American dollar that accompanied the constitutional reforms, many people in the three special overseas municipalities are struggling to make ends meet as it is. The obvious risk is that the persons in question no longer would seek the treatment they require, with all possible consequences for their condition. Not only that, but the latter could lead in reality to higher rather than lower medical cost, because there might be ensuing complications that demand even more expensive procedures later.
Certainly in this day and age when the worldwide focus is on prevention rather than cure, the move appears ill-advised at best. In addition, the fear that it might make this type of care less accessible due to a lack work for the professionals involved is not entirely unfounded. The government in The Hague needs to keep in mind that on an island the volume of demand determines the available provisions offered, based on the economies of scale.
I seriously doubt the circumstances in the European part of the Netherlands are so much different from the Caribbean Netherlands. The switch from the guilder to the dollar might be more recent than that of the switch from the guilder to the euro, still the introduction of the dollar is already a few years ago and the result of it is quite equal to that of the euro. A valid argument to call the situation different is the lower wages and welfares on the BES-islands compared to the European Netherlands. This inequality should be high priority in The Hague. On the other hand, unemployment is (significantly) lower in the Caribbean Netherlands than in the European Netherlands (6.2% on Bonaire, 4.9% on Statia and 4.4% on Saba, compared to 12.5% in Flevoland and 11.4% in Groningen. Even Zeeland, the province with the lowest unemployment rate in Eur-NL, has a greater unemployment than Bonaire (6.5% to be precise).
Am I saying that the crappy system with a health care insurance that doesn’t cover everything should be introduced in the CNL, just like in the ENL? No, rather the opposite. The abolition of the “health care fund”, the state-controlled fund that covered health care for everybody, was a mistake and should be reintroduced. Nationwide, on both sides of the ocean. That way, everybody can rest assured that, whenever something happens to you, your health costs are covered. No “money pumping around” by having to apply for health care allowance to be able to pay a huge insurance bill each month for an insurance that doesn’t cover everything. No more people who won’t go to the doctor anymore because they fear they’ll get in (more) financial trouble. Health care should be open for everybody, the rich and the poor!