By Karin Brennan
One inattentive moment was all it took to alter a long-planned, three-week European vacation. On my first morning in Amsterdam, I missed a step when heading for breakfast in my hotel. The next thing I knew, I was on the tile floor, dazed and bleeding. I immediately knew it was not good and that a hospital visit was in my immediate future. But, in Amsterdam? What would this cost? What kind of care would I get? As a taxi took my husband and I to the closest hospital, I was more than a little apprehensive.
What follows is my firsthand experience with the (emergency) healthcare systems in the Netherlands and Germany.
Our taxi arrived at the emergency room of the closest hospital on a Saturday morning, at about 10 a.m. Every time I tell this story, people tend to groan in empathy, assuming a potentially endless wait. To our surprise, there were only 2 other families in the waiting room. My husband checked me in at a reception window and described what happened. He provided my passport and was asked for information about where we were staying and how long we planned to be in Amsterdam. He was then asked to pay 250 euros for the visit, which he did.
Within a half hour, I was taken into an examining room where we met a nurse and the attending physician. It was quickly determined that a CAT scan was needed because I bumped my head in the fall, and that an X-Ray would also be done on my affected ankle. About 30 minutes later, an orderly took me for both tests. Tests completed, I was returned to the examining room to wait for the results. Within an hour, I had them; a mild concussion and a small broken bone in my ankle. I was told a night in the hospital was necessary for observation and to satisfy their concussion protocol. My most visible injury, a torn upper lip, was also addressed at this time. About 20 minutes later, a temporary cast was applied to my lower left leg and I was fitted for crutches.
At this point, we didn’t know what the total cost would be, but assumed our bill was growing. Regardless, we agreed to the plan of treatment. Within the hour, I was moved upstairs to a room. The elapsed time from emergency room arrival to hospital admission was less than four hours.
With my husband back at our hotel, I settled in and nurses provided routine neurological checks and monitored my vitals throughout the day and overnight. The room was pleasant and had an advanced (based on my experience) personal entertainment system, including internet access. Instead, I talked to the nurses, asking them about how their healthcare system worked and how they felt about their jobs. They meet quite a few American tourists and most of us are apparently surprised about the quality of the care as well as the cost. After seeing the doctor again, I was released early the next afternoon. I was given a CD containing my test images, instructions for the next stage of care for my ankle, and appropriate medications. While we did pay extra for the crutches and medications, the total cost of the care itself was the initial 250 euros, the equivalent of about $290.
Because my cast was temporary to allow for swelling, it needed to be replaced in one week with a walking version. Since our travels required mobility that one working foot could not provide, we elected to buy a wheelchair in the interim. One week later, we were in Wuerzberg, Germany, and embarked on another visit to a hospital emergency room. Again, a taxi brought us to the closest hospital on a Saturday morning. While the process was somewhat different, the elapsed timeframe and cost were remarkably similar. Less than two hours and 204 euros later, our visit was successfully completed. Most of the cost was for the high-tech walking boot, which served me well for the remainder of the trip. I have family in Germany, and we ended our visit with them, talking about their taxation rate and what they received in return. They do not feel unfairly taxed and are satisfied with the services they receive.
My findings were consistent in a few ways. First, almost everyone we met spoke excellent English, which made the experience much less stressful. Neither emergency room was very busy, because their citizens have access to primary doctors who generally serve as their first medical contacts. Cost was not a critical consideration; healing was. The doctors and nurses did not appear unduly stressed and, in the Netherlands, all introduced themselves and shook our hands. I saw this happen routinely with all the other patients, too. In the hospital, no unnecessary tests were done. When I rang for assistance, someone showed up promptly to help. I should add that I watched the care of an elderly patient who was brought in during the night. The next day, I talked with her family about their experience with her extensive, ongoing issues. While they cared for her primarily at home, they were there quite often and felt supported in her care.
I realize that my experience was limited and occurred in two of the most advanced countries when it comes to nationalized healthcare. But, what I saw were systems that apparently work for the people they serve. Given the growing evidence that a for-profit healthcare system has inherent conflicts of interest built in for companies looking to maximize investor returns, it seems time for a serious effort to create a less predatory system in the U.S. Our government has the power to do this, but currently sides more with big companies with the most to gain. As for me, I didn’t see a “failing” healthcare system. What I saw was a system that did not feel cumbersome, confusing, and efficiently helped me with my issues. My healing began and I got back to living my life.
And, Oktoberfest on crutches was still fun.
The author is a U.S. Army Cold War veteran who served three years as a German linguist (Army Security Agency) behind the Wall in West Berlin. She has an MBA in Marketing and is retired after a 27-year career at IBM as a Senior Marketing Manager. She’s married and lives in Carlsbad, CA.