Health care in Holland

We should not complain about our health care system. People in such advanced European countries as Netherlands have it much worse. I just saw a 27-year-old Dutch woman with chronic migraines who has been coming to see me for Botox injections every three months for the past 3 years. Three years ago she was told by her neurologist to quit law school because even if she was able to graduate, her migraines will prevent her from being able to hold a job. She is graduating from law school this June. Her doctors also told her not to take sumatriptan (called Imigran in Europe and Imitrex in the US) more than once or twice a week and take only aspirin on other days. This approach made her unable to function on the five days when she did not take sumatriptan, but even with sumatriptan her headaches were still disabling. Botox injections produced a significant improvement in the severity of her attacks, although not in the frequency. However, now sumatriptan provides complete relief and she can function normally. She tried to find a way to get Botox injections in Holland and offered to pay the doctor. He was not able to do it because medicine is socialized in Holland and he could not accept payment for procedures not covered by the health service. She turned to the government and offered to reimburse the health service for Botox, but they also refused. She is fortunate in that she is able to afford to come to New York every three months and buy as much sumatriptan as she needs to function normally.
Things are not much better in the UK and other European countries. The UK approved the use of Botox for chronic migraine before it was approved in the US. However, their national health service also refuses to pay for it. My Italian colleagues have told me that as a society they’ve decided that Botox was too expensive to be used for the treatment of migraines, despite the evidence that it works. I should note that just like many other drugs, Botox is significantly cheaper in Europe than in the US.

  1. Dr. Mauskop says: 05/27/20124:32 pm

    Actually, in Holland, Canada, and many other countries neither poor nor rich can get some of the necessary care or you have to wait for six months for a test like an MRI scan, even if you are suspected to have a brain tumor. One Canadian did not want to wait, came to Buffalo, paid for a scan and did discover that he had a brain tumor. When he went back to Canada he was told that the earliest appointment to see a neurosurgeon was in three months.
    The patient who came to see me from Holland did not come for sumatriptan, but to get Botox injections, which is the only treatment that ever worked for her and which she could not get in Holland, even though she was willing to pay for it.

  2. Sophie says: 05/27/201211:58 am

    Kind of a distortion of the overall picture there. Yes, if you’re rich then healthcare system in the U.S. is great! If you are poor or middle class, its a mess, and the European, Japanese and Canadian models are far better. Maybe the first sentence should be changed to “If you have money, you should not complain about the health care system in America”.

    And also the lady is wasting her money flying all the way to New York City just to get Sumatriptan. There’s a ton of countries in Europe she could travel to and get a bulk supply. I know this for a fact, one of my friends live in Germany and has no problem getting it whenever he wants.

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