Healthcare in Holland

| Mon May. 4, 2009 9:28 AM PDT

So what does Russell Shorto think of Dutch healthcare after spending 18 months in Amsterdam?

My nonscientific analysis — culled from my own experience and that of other expats whom I’ve badgered — translates into a clear endorsement. My friend Colin Campbell, an American writer, has been in the Netherlands for four years with his wife and their two children. “Over the course of four years, four human beings end up going to a lot of different doctors,” he said. “The amazing thing is that virtually every experience has been more pleasant than in the U.S. There you have the bureaucracy, the endless forms, the fear of malpractice suits. Here you just go in and see your doctor. It shows that it doesn’t have to be complicated. I wish every single U.S. congressman could come to Amsterdam and live here for a while and see what happens medically.”

Amen to that.  But there's also this:

One downside of a collectivist society, of which the Dutch themselves complain, is that people tend to become slaves to consensus and conformity. I asked a management consultant and a longtime American expat, Buford Alexander, former director of McKinsey & Company in the Netherlands, for his thoughts on this. “If you tell a Dutch person you’re going to raise his taxes by 500 euros and that it will go to help the poor, he’ll say O.K.,” he said. “But if you say he’s going to get a 500-euro tax cut, with the idea that he will give it to the poor, he won’t do it. The Dutch don’t do such things on their own. They believe they should be handled by the system. To an American, that’s a lack of individual initiative.”

I actually ran into that once myself.  Back in my marketing days, I was once in charge of a product launch that, among other things, included a contest for the salesperson who sold the greatest amount of our new gift to the high-tech world.  Pretty standard stuff.  So I went on the road for a couple of weeks presenting the new product to our distributors in the U.S. and Europe, and everything went basically as expected until I got to the Netherlands.  They didn't like the contest.  Why?  Because it singled out a single individual who did especially well, and this was unfair since sales was a team effort.  They wanted a contest that rewarded whichever group sold the most stuff.  And they were pretty serious about this.  They really, really didn't like the idea of a single person being held up as an individual success.

I've always remembered this as a good example of how ingrained our own cultural predilictions are.  At the time this happened I'd been dealing with European distributors and resellers for over a decade, so I was already pretty familiar with the various cultural differences in how sales teams worked.  But this one came out of nowhere.  It never occurred to me for even a second that anyone would object to a sales contest.  Why, it's as American as apple pie!  Which, it turned out, was exactly true.

On the other hand, no one else had a problem with it.  Only the Dutch.  And it still strikes me as an odd attitude.  But they run a pretty nice country over there, so I guess it works pretty well for them.

More here from Steve Aquino.

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Comments

Spare us the BS about rugged American individualism

But if you say he’s going to get a 500-euro tax cut, with the idea that he will give it to the poor, he won’t do it.
Oh, and an American will? Yeah, right. He'll buy a big-screen TV with it. The US isn't exactly a hotbed of independent thinking, either. Millions of Americans are proud to be "dittoheads".

Dykes

Considering that the country would have perished many times over if not for the collective, collective, collective, collective, collective project of creating a system of dykes, locks, etc., I don't really see why you should find this surprising. Also, I would point out that giving people a tax break with the expectation that they will spend it on charity, is stupid. The Dutch reaction to that poser is completely rational. Unlike us, they realize that a social net has to be obligatory or else you end up with a really sucky social net, like we have in America. So again, that does not seem like much of a proof of mindless conformity.

Coffee's for closers.

Coffee's for closers.

"They didn't like the

"They didn't like the contest. Why? Because it singled out a single individual who did especially well, and this was unfair since sales was a team effort." I would like to add that by not sharing selling ideas due to wanting to win the contest, the company gets hurt. I see it all the time. Why would you share a good idea with your fellow salesperson if it is he that you want to beat?

I think the Dutch view is

I think the Dutch view is probably more enlightened than ours. No man is an island, after all. The cult of the individual has done a lot more harm here and globally than collectivist thinking has.

tall poppy syndrome

The Australians refer to it as tall poppy syndrome: "a tall poppy will get its head cut off".

Your example is interesting

Your example is interesting and it sure fits my experience with the Dutch. However Russell Shorto is being silly. It can be perfectly rational to accept a 500 Euro tax increase for the poor but not give money voluntarily to the poor. They are totally different choices. The point is that even if I would rather keep my money than give it to the poor, I would rather your money went to the poor. With a tax increase I pay more but millions of other non poor people pay more too. Same cost to me, much greater benefit to the poor, much greater cost to other non poor people who 1) don't need the money as much as the poor do and 2) aren't me. The idea that there is something strange about supporting higher taxes for antipoverty programs yet not giving more to the poor is strange, illogical and nonsensical. Shorto seems to believe that the Dutch are not generous with their own personal money. I recall reading somewhere (no link sorry) that a very large fraction of Dutch people (over 10%) are regular donors to Medecins Sans Frontieres. I'll believe claims that collective action undermines private charity when I see some solid evidence.

The Dutch seem smart

The Dutch seem smart about that fake scenario of getting a $500 tax cut to then pass on to the poor. C'mon, that scenario is ridiculous, and most Americans wouldn't send a dime of that tax cut to the poor, no matter what they said. Indeed, if you really thought that the poor should be helped to a certain extent, a rational person would want this tax to be shared by everyone, not set up so that only some contributed the money while others defected. This is the intersection where prospect theory and public choice collide.

Speak for yourself.

"I've always remembered this as a good example of how ingrained our own cultural predilictions are" Speak for yourself, kimosabe. As a born-and-bred multi-generational American, I hate the self-promoting culture of competition we have here. Enthusiasts for that have always struck me as the dumber swath of America: sales, sports, high finance, (mostly male), whatever. Furthermore, selfish competition is either orthogonal to, or actually in opposition to, independent thinking. Dutch scientists, for instance, are pretty good, especially per-capita. As for the tax example, I agree with the other posters that it is ridiculous, and I'm surprised someone could cite it without recognizing that it is an argument every liberal must have thought through in explaining why he isn't a libertarian. It presumes a libertarian outlook that it is better to work through individual charity than collective spending. I believe in taxes because it is a good way to prevent shirking. Those Bush tax rebates did much less good for the world in individual pockets (and a few charities) than they would have as part of, say, a government health program.

Enthusiasts for that have

Enthusiasts for that have always struck me as the dumber swath of America: sales, sports, high finance, (mostly male), whatever
And didja ever notice how most of them refer to themselves as "team players" while they're throwing elbows to get to the top of the heap?

I think the American midwest is like this...

... and maybe elsewhere like Northern California and the Pacific Northwest. There was in my upbringing in Illinois by Iowa and Michigander parents -- a real aversion to individual success. Always the group should be praised. Groups should be held as a model for action. AP classes, tracking, awards banquets, were regularly held up to be as practically un-American. That we did not value individual difference, but our barn-raising ethos was one for all and all for one. Now the East Coast, with its old world attitudes, always seemed to me to be more focused on dog-eat-dog and individual achievement. (My son/daughter is an honor roll student... kind of world.) christopher // inaudiblenonsense.com

That may very well be

That may very well be because of the substantial Dutch and Scandinavian immigration to those regions.

Team or Individual

I think the American sports system is terrific. We get kids to play with other kids in structured ways and they begin to learn about collaborative efforts. But, we also praise the individual if they are outstanding. Sometimes we focus too much on the pitcher or the quarterback or whatever, but there are plenty of stars.

Jante Law

This isn't very surprising. In Scandinavia we have the so called Jante Law which enshrines this mentality http://en.wikipedia.org/wiki/Jante_Law The Dutch are probably the people in Europe most similar to Scandinavians, most likely because we share a history of contending with unforgiving forces of nature (the climate in Scandinavia, the sea in the Netherlands) thus developing a strong colectivist ethic.

Chauvinism

I've been thinking about this post all day, and I realized what bothered me so much about it was how provincial Kevin comes off as. So he approvingly quotes some guy who apparently finds it odd that the Dutch don't favor a tax program that is guaranteed to scupper the welfare state, and then is baffled at the Dutch preference for communitarian thinking. Did Kevin delete a final paragraph professing surprise at the fact that the Dutch don't know the rules of baseball? In the guise of pointing up the oddness of the Dutch, Kevin ended up demonstrating the oddness of the Americans, and (since Kevin is worldly) that depresses me.

@ Sigmund, I also believe a

@ Sigmund, I also believe a large share of our shared sensibilities come from a shared Calvinistic background. Also Buford Alexander shows an extreme lack of knowledge of dutch charity work and house hold donations. Even without the percentage of taxes already going to charity total household donations of money and time rivals that of the USA and surpasses it in many cases. And yes, donations are tax deductible like here in the United states. His statement is, to be charitable, confused at best.

Yeah, right. The Dutch guy

Yeah, right. The Dutch guy would refuse to donate his 500 euros, but an American would be handing out cash at a walkathon. As if. Americans are just as stingy as any nation on Earth. The difference is the American will bitch and moan about giving to the poor whether it's done collectively or individually. Or rather whether it is *not* done. They complain about all the free rides that America gives to poor black and brown people, and all the foreign aid we give around the world. Except they don't really do much of either. And I don't believe them if they say they give money to the poor. And those Dutch salesmen were not weird, they were just smarter than the rest of your company. Why kill yourself in a competition where the odds are so far stacked against you as an individual, only to watch someone who probably benefited from your work or the work of your team enjoy the whole shebang? It's like a lottery, except instead of throwing away money, your throwing away time and effort.

The nail that stands up must

The nail that stands up must be hammered down.

Pie

Apple Pie is American??? I am sure we were making it in Holland before the Pilgrim Fathers even left...

It's difficult to make apple

It's difficult to make apple pie without apples. They aren't native to the Americas:

In the English colonies the apple pie had to wait for carefully planted pips, brought in barrels across the Atlantic, to become fruit-bearing apple trees, to be selected for their cooking qualities, as apples do not come true from seeds. In the meantime, the colonists were more likely to make their pies, or "pasties", of meat rather than of fruit; and the main use for apples, once they were available, was in cider. But there are American apple-pie recipes, both manuscript and printed, from the eighteenth century, and it has since become a very popular dessert.

I live in Holland, they are

I live in Holland, they are collectively scared. Nothing to do with enlightment, just fear of succes, of standing out, of being alone. If someone excells, this one isn't being respected but bullied.
They are like ants, afraid that their anthill collapses.

That would work fine, if not some of us, like me, is feeling encaged, not able to follow my own life and divine path but stuck to people I don't know. That we built another anthill without competing them, doesn't comes to their minds. With our health system, we deliver our care very soon to strangers, nobody cares for another, we pay others to do that.

We live collectively in a lie, thinking we can achieve safety, buy health but our raw nature lurks within. Only one extremist need to adress them and our misguided and denied emotions will blow up in our face.

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