Okay, non-Dutch cancer patients. Prepare to be jealous.
I had my arbo doctor appointment this morning.
A few weeks ago, a letter arrived in the post, written in Dutch, requesting that I meet with the arbo doctor and notify my company if I cannot attend. Then a woman from Human Resources called me to ask if I received the letter. I asked her what it was all about, because we have nothing like this in the States.
Apparently, by law, all employees who are absent from work for more than 5 days meet with an arbo doctor. I didn't need to bring or prepare anything for the meeting, and Human Resources insisted that I take a taxi to the meeting and back.
I asked a long term resident about the arbo doctor and she said not to worry; the company is absolutely not checking up on me. In fact, the arbo doctor will typically take sides with the patient over the company. They are there to ensure that the employee is not overworked during his/her illness and to ease the transition back to work. Sometimes they insist, for example, that an employee on maternity leave only work half-days for the first week they are back in the office.
The arbo doctor asked me a few questions about my diagnosis, treatment, and its side effects. He also explained that I could not legally lose my job for up to two years. The first year, I would continue to receive 100% of my salary. The second year, I would receive 70%. The doctor showed me the form he was completing to send to my company, which legally could not mention my diagnosis or specific side effects; mostly it just stated that I had been working approximately 20 hours a week due to problems with fatigue and concentration, resulting from my treatment. He was careful to tell me that stating this number in the letter was by no means binding me to work 20 hours a week. Also as required by law, we will continue to meet every 6 weeks by telephone or email throughout my treatment.
Wow. While I've never been sick for more than 5 days in the U.S., I'm pretty sure that's not how it works there. My former company combined sick and vacation days, and we had 20 days in total. I know I had short-term and long-term disability benefits, but I never bothered to look at the fine print, so I have no idea whether it is anywhere near as simple or comprehensive as the Dutch system.
My cousin just sent me a link to an article in the New York Times that goes on quite a bit about the 52% tax rate in the Netherlands. The article mentions some of the benefits citizens get as a result, but not this one. I am feeling truly thankful that I am here at this moment...and also a little bit guilty, as I don't even pay the 52% tax rate. As an expat, I get a big tax break called the 30% ruling, which means that I don't get taxed on the first 30% of my income. Oh well: one doesn't turn down free money!
Showing posts with label Dutch vs. American health care. Show all posts
Showing posts with label Dutch vs. American health care. Show all posts
Monday, May 4, 2009
Monday, March 2, 2009
First Contact with the Dutch Health Care System
On the afternoon of March 2, I paid a visit to our Human Resources representative on the second floor. Luckily, she was in. She only works a few days a week at our site, and I hadn't memorized which days. I showed her my lump and explained that I had no regular physician, seeing as I had not had any serious illnesses in the 2 years since I moved to Amsterdam and never got around to translating all the insurance literature I had been receiving in Dutch.
She was concerned. She called a few doctors for me, but the earliest available appointments were for Friday and it was only Monday. She suggested then that she drive me to the emergency room at the AMC, the academic medical center which happened to be just a few blocks from the office anyway.
The AMC struck me as a bit disorganized (and in fact, I was later to have this impression during many interactions with the Dutch health care system). The uniformed security officer waved me in to another room, where a nurse was supposed to do intakes. The nurse explained that there were 2 others ahead of me, so please take a seat in the waiting room. But she didn't take my name or give me a number, or even ask what my problem was, so I wasn't sure whether she was going to remember me or in what order I arrived. And 'triage' didn't seem to be in effect. The couple that came in after me, with a kid whose hand was bandaged up, received the same handling. They were Dutch, but just as confused as me, because they tried to go back to ask if they shouldn't at least provide a name, but the nurse waved them into the waiting room again.
More and more people trickled in. About 30 minutes later, the security guard came in and pointed at me. "You're next". And then he pointed at two other people in the waiting room in turn. "And then you, and then you." So, they were paying attention after all.
But the 30 minute wait was just to get my intake interview. I explained in Dutch that my Dutch wasn't that great so perhaps it would be easier if I continued in English. "Easier for you maybe, but not easier for me", the woman replied back in Dutch. Oh okay. It wasn't so much that I didn't want to use my Dutch, but over the years in Amsterdam, I had been conditioned to think that most people preferred to speak English with native English speakers whenever they could.
We muddled through and I felt a brief sense of accomplishment afterwards. If nothing else good came out of this, at least I could see that I was making some progress with the language.
An hour later, I was sitting on the hospital gurney showing the first of three medical professionals in succession my lump. It seemed to me, though I can't be sure, that the three all had different types of clothing, indicating perhaps that the first was an intern and the second a resident, and the third a bonafide doctor. They asked questions and prodded around the area of the lump. The second professional told me that he didn't think it was coming from the breast area, and so it probably wasn't breast cancer. None of them would say anything more specific than that about the lump itself. The third professional told me that this did not qualify as an emergency and that I should make an appointment with a regular physician. Oh, I didn't have one? He asked where I lived and luckily, he knew of a good one whose office was just down the street from me.
When I got back to my own office, just one stop away on the Metro, I called and was able to squeeze in an appointment for Wednesday afternoon, which was a lucky break because I was leaving for a business trip to Milan on Thursday.
She was concerned. She called a few doctors for me, but the earliest available appointments were for Friday and it was only Monday. She suggested then that she drive me to the emergency room at the AMC, the academic medical center which happened to be just a few blocks from the office anyway.
The AMC struck me as a bit disorganized (and in fact, I was later to have this impression during many interactions with the Dutch health care system). The uniformed security officer waved me in to another room, where a nurse was supposed to do intakes. The nurse explained that there were 2 others ahead of me, so please take a seat in the waiting room. But she didn't take my name or give me a number, or even ask what my problem was, so I wasn't sure whether she was going to remember me or in what order I arrived. And 'triage' didn't seem to be in effect. The couple that came in after me, with a kid whose hand was bandaged up, received the same handling. They were Dutch, but just as confused as me, because they tried to go back to ask if they shouldn't at least provide a name, but the nurse waved them into the waiting room again.
More and more people trickled in. About 30 minutes later, the security guard came in and pointed at me. "You're next". And then he pointed at two other people in the waiting room in turn. "And then you, and then you." So, they were paying attention after all.
But the 30 minute wait was just to get my intake interview. I explained in Dutch that my Dutch wasn't that great so perhaps it would be easier if I continued in English. "Easier for you maybe, but not easier for me", the woman replied back in Dutch. Oh okay. It wasn't so much that I didn't want to use my Dutch, but over the years in Amsterdam, I had been conditioned to think that most people preferred to speak English with native English speakers whenever they could.
We muddled through and I felt a brief sense of accomplishment afterwards. If nothing else good came out of this, at least I could see that I was making some progress with the language.
An hour later, I was sitting on the hospital gurney showing the first of three medical professionals in succession my lump. It seemed to me, though I can't be sure, that the three all had different types of clothing, indicating perhaps that the first was an intern and the second a resident, and the third a bonafide doctor. They asked questions and prodded around the area of the lump. The second professional told me that he didn't think it was coming from the breast area, and so it probably wasn't breast cancer. None of them would say anything more specific than that about the lump itself. The third professional told me that this did not qualify as an emergency and that I should make an appointment with a regular physician. Oh, I didn't have one? He asked where I lived and luckily, he knew of a good one whose office was just down the street from me.
When I got back to my own office, just one stop away on the Metro, I called and was able to squeeze in an appointment for Wednesday afternoon, which was a lucky break because I was leaving for a business trip to Milan on Thursday.
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