US-Like Health Insurance System Huge Political Issue

20160830_131857Amersfoort, Netherlands   In the exactly six weeks since I visited organizers of the national health funds campaign in Holland, the campaign has continued to explode. When I first sat down with them at that time they had about 40,000 responses to their campaign with a little more than half asking for tool-kits to take more action. Now, a mere six weeks later and during the summer when the pace of action, campaigns, and seemingly everything else in Europe dissolves into holidays, the numbers had ballooned to almost 120,000 responses and close to 50,000 requests for tool-kits.

Walking into the Socialist Party of Netherlands building in Amersfoort, which is housing and managing the campaign thus far, a giant conference room is filled with tables, one after another. The first night of my visit when I walked out of the building at 8:55 PM there was a crew of 15 members walking up and down in assembly-line fashion collating the packets for mailing. When I walked in early the next morning, looking to my left at the conference room a half-dozen volunteers were still walking along the tables putting the packets together. I jokingly asked them if they had been their all-night, and they responded they were “slaves” to the task. The flipchart indicated they now had close to 50,000 packets assembled.

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Later in the day the head of the IT department displayed the health campaign analytics on a screen behind him. There had been a spike to 7000 unique visitors the previous day in reaction to a news conference where one of the campaign activists, a health care worker, had talked about the peril to “on risk” citizens who were paying the mandatory annual fees to the private company insurers, but were part of the 20% of the population who avoided going to hospitals at all costs in order not to pay the additional 385 euros when they actually accessed the system.

Disapproval of the plan is not only driving the campaign but increasingly becoming a central issue in the political environment of the Netherlands. In a multi-party system where there are as many as forty political parties of all shapes and sizes in this small country, positions on change to the privately directed national health plan is becoming the line of demarcation between the parties. As the campaign has grown several of the larger parties have argued that they will change the payment system and lower it in some way. The SP/N has been the most aggressive, not surprisingly given their role in supporting the campaign, in saying that the “on risk” payments should be eliminated and the system returned to its previous situation as a national health fund, and in fact caused some stir recently by saying that it would not join a future government without such a pledge. With national elections distributing parliamentary seats only a bit more than six months away, healthcare is clearly at the center of the debate just as it has been in the United States, the United Kingdom, and other countries in recent years.

Most of the meetings I have been in have been focused on how to scale up a field program that maximizes the opportunity for change on this campaign. Predictive dialers, robo-calls, large scale door knocking efforts, extensive networks of house meetings are not as common in Dutch campaigns as they are in the US and Canada, and organizers are looking to master much of this organizing methodology in coming months in order to scale the campaign sufficiently to leverage the political season to create extensive change around national healthcare in the country.

This may be a small country along the water and under sea-level, but they may make waves all over Europe with a victory on this issue.

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