What if the fates of the two competitors in Sunday’s final were to be decided through their approach to health and social justice, as opposed to a lucky kick of a ball?
 At Hesperian, as with much of the world, football fever is in the air as the final of the World Cup approaches. Isolated whoops of victory and cries of defeat can be heard around the office, as staff members surreptitiously (or not-so-surreptitiously) keep an eye on their favorite teams. Comparisons and discussions are inevitable, and it didn’t take long to connect the game with the subject that is  constantly on our minds here: health. What if the fates of the two competitors in Sunday’s final were to be decided through their approach to health and social justice, as opposed to a lucky kick of a ball?
Given the similar nature of the two countries, comparing their health systems would at first appear to be a yawn-inducing draw. Both the Netherlands and Spain have universal health care for their citizens; both are in Western Europe; and both are members of the European Union. Here in the US, where universal access to quality care is still a frustratingly distant goal, we wish we had anything like our finalists. But even with such enlightened rivals, quality health and especially health care equality is not assured.
The Netherlands uses a dual-insurance system of national health care, with long-term treatment and high-cost items such as wheelchairs covered by the state, and shorter-term procedures covered by mandatory private insurance, which is paid for by the individual and her or his employer. Spain, on the other hand, has a national health service that is all-inclusive and can be used by all residents. It is important to note that neither nation covers the important fields of dentistry and eye care. In both countries, citizens must buy private insurance for these.
Perhaps the biggest distinction between the health care in these two countries is how they treat undocumented immigrants. This is one of the many gaping holes in the recent US health reform, with the nation’s 7 million undocumented immigrants living in third-world conditions because of a lack of basic care. It seems that the Netherlands is not much different. Although they possess a wide social safety net, the Dutch do not extend it all the way down the social ladder. Undocumented immigrants do have opportunities to get care, but are often discouraged by doctors, the medical system, and other factors. Spain, in contrast, passed a law in 2002 extending full medical coverage to undocumented immigrants and there is little detectable difference between their access to care and that of the average Spanish citizen.
When the teams line up for the final this Sunday, there’s no telling who will come out the victor. In terms of equality in health care, however, the answer is clear: ¡VIVA ESPAÑA!
* Thanks to Public Health Consultant Mona Sheikh Mahmud for sending in this article from the Hesperian blog. |
