My first doctor’s visit this month was a bit awkward because — and only because — I WAS AWKWARD! I was a stiff person lurching around trying to hand the receptionist my identification card, my insurance, card, ANYTHING?! “That won’t be necessary….” she said, looking at me like I pulled out a mushed up fluffernutter sandwich on US-grade wonder bread and asked if she was hungry.

There’s no co-pay. I do not need to hand her my insurance card because in the Netherlands information is shared between agencies that manage things you need to live — no special photo-copied, triple-clicked, endlessly-authorized-but-never-used-medical privacy data-sharing form needed. Clear. Free.

Zero. That’s what it cost me this month when I went to the doctor’s here in the Netherlands for the first time. And the neurology appointment they scheduled me for one week after. And the bloodwork they sent me to. And the CAT scan. And the vaccines. Zero co-pay. Zero bill after the fact. Zero.

But if I don’t give you something, is this even happening?

I pay €198 a month for health insurance. My kids are covered under my insurance for free. FREE. Free. FREE.

My joints feel lighter just telling you this. I’ve never felt so hopeful about my financial life + medical care while living with MS.

To give some context of WHY my elbow tendons join a symphony of non-vigilance with the rest of my body after this routine medical experience, you should know that in the seventeen years I’ve been living with MS, I’ve declined at least 50% of the MRI scans my doctors order to track my MS progression to see how many more brain cells my immune system has gobbled up. I declined these because I was regularly “paying off” my “portion” of those scans, even though I had health insurance. My portion of the bill ranged from hundreds to thousands of dollars I was required to pay out of pocket while making anywhere from 15,000-30,000 a year.

The only reason I received the medication I needed to slow-walk the debilitating features of Multiple Sclerosis for the last 15 years is because the corporations that make and over-charge for the medicine “pay” for a large portion of it if I enter their “copay program,” through which they presumably also use my data for long-term research.

And the day-to-day costs of medical care while raising kids in the US are relentless. My kid has a rashy fever and needs an antibiotic? $20 to talk with a doctor on the good years, $40 on the bad. A Med check to simply say “how’s this going?” $20. Each visit. No question about it. Broken arm? Hello emergency room bill from three different doctors.

My guess is, if you’re reading this, you’re from the land of the $3k+ medical bills. You’ve seen some shit. You’ve got your stories. NPR has an entire series called “bill of the month” where you can read about Vincent, who was handed a bill for emergency medical care as he was CLIMBING ONTO THE MEDIVAC LIFEBOAT or Caitlyn who spent many, many hours over many weeks fighting a $139k bill for a pre-approved surgery. It’s truly, TRULY unacceptable. And in the US, we live with it — kicking and screaming and organizing and moving to different states and twisting our life into pretzels and staying at brain-and-body-numbing jobs instead of starting our own projects — because we must or we die.

Meanwhile, here in the Netherlands…

Kids are free. Covered under my health insurance free. Federally required to be free, free. When we finally got the kids’ magic residency numbers, I went to my (not-for-profit cooperative) health insurance portal and signed them up that night. That night. Free. Almost all of their healthcare and treatments are covered. Free. US

I went to my general practitioner so I could get started through the process of getting my every-six-months MS infusion. I was prepared for this to take a long time, and made a plan with my previous Neurologist to go up to a year without it if need be. He referred me to the Neurologists on a Monday and they scheduled me for an appointment THE NEXT MONDAY. I saw the neurologist and she sent me to 3 other appointments to get me set up my baseline in their system, which included CAT scans, blood draws, and praise all that is holy VACCINES!

As an immune compromised person, I felt like I had to bring linebacker energy to the US system to get vaccines over these last five years, and this is even harder since the long arm of nepotism, anti-intellectualism, and failing up landed the Chief AntiVaxxer in a cabinet position. I think Netherlanders know this about Americans, because my doctor kept asking me, “are you okay with these vaccines, yes? This will be okay with you?” So okay. It is so okay for me to not get shingles, thank you.

There was an MS Nurse desk in the Neurology department. They told me to walk up and schedule all the rest of my appointments with her and ask her all my questions at any time during the three days a week the desk was open. ANY TIME.

Of course, there are things that take some adjustment, like appointments scheduled without me saying if I’m available. I had a very Kafkaesque experience trying to get medical clearance to get a drivers license. As I gather more data I’ll share more updates from inside the Dutch medical system, but so far the contrast is noted and welcomed. Come on in, the water is pretty damn fine.

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