Tuesday, August 20, 2013

Things that are different, so far, part 3

Ever since we decided to move to the Netherlands a large number of our friends in the US greeted the news with a common refrain, "at least now you will be able to get health care". You see I am a Type 1 diabetic and because of this it has been years since I have had health insurance in the US. My last employer offered health insurance and having a pre-existing condition wouldn't have prevented me from obtaining insurance through my employer. But for the first year the insurance would not have covered anything relating to my diabetes. I had went through this before and found that during that first year an insurance company can find a way to claim that anything that happens to you is related to diabetes. So I would have worthless insurance that I would have to pay full price for, not a great deal. This predicament is no longer a problem for me.

Today my husband and myself signed up for health insurance through his employer. Some people may be surprised that it came through an employer. They might also find it shocking that our insurance isn't provided by the government. Our insurance comes from a private company. We get to choose our own doctors, choose which pharmacy we purchase our medications from, decide what we wanted our deductibles to be, and thoroughly customize our health care coverage. Is this not what you were expecting from socialized medicine? That's because it isn't socialized medicine. You see the Dutch government doesn't own the pharmacies or hospitals, the doctors don't work for the government, the insurance companies aren't part of the government (although the government does directly provide health care coverage for the poor and elderly like the US government does through Medicare and Medicaid). Socialism involves government ownership of an industry, so this is not socialized health care, it is simply highly regulated health care. It is actually fairly similar to Obamacare (it was even more similar to Obamacare before the legislation was dramatically reduced in effectiveness for solely political reasons by the Republicans), and according to everyone we have spoken with, it actually works.

So at the insurance office today we were allowed to choose which deductible we were comfortable with. After we meet the deductible for the year 100% of our health care expenses will be covered. My deductible is €350 per year and since 2/3rds of the year is already gone 2/3rds of my deductible is as well. That's right, they pro-rate your deductible. I will have to find a general practitioner, known as a "house doctor" here and yes, they make house calls, and I assumed the first visit to my new doctor would eat up most of my deductible. When I said this to the woman helping us at the insurance office she looked confused, you see visits to your house doctor are always 100% covered by your health insurance. She told us that these visits were at no cost to us because if you are sick you need to go do the doctor and if you had to pay to see your house doctor you might not go. I consider this amazingly logical logic. We also found out that medications are VASTLY cheaper here, same drugs made by the same companies just completely different prices. We decided to skip dental insurance for now based on the fact that dental care is actually really affordable. Need a filling? €50.

Many Americans upon hearing the low cost of medical care here might assume that no one would want to be a health care provider, interestingly there doesn't seem to be any shortage of health care providers here. The biggest problem is that it can take a small amount of work to find a house doctor, not because there aren't plenty of them, but because the government limits the maximum number of patients a house doctor can see to help make sure that all of the patients receive good care. Waiting for health care isn't really a problem here as obviously, even with the government's regulations and price controls, health care providers can still make a decent living. Doctors may not be millionaires here, but they aren't hurting either.

So we get low costs, great care, lots of choice, and limited waiting for care, how is this a bad thing America? Why should only the wealthy receive good health care? Why has America created a health care caste system where having a small bank account is almost a symptom of a terminal illness? America can do better, the question is why doesn't it want to?

Sunday, August 18, 2013

Things that are different so far, part 2

One of the hardest things for me to get used to in the Netherlands has to be the hours the local stores are open. Most of the stores here close at 6:00 pm. A couple of grocery stores stay open till 8:00 and restaurants tend to stay open later but over all this city shuts down at 6:00. Except of course for Thursdays. Everything stays open till 8:00 or 9:00 on Thursdays which seemed pretty odd to me until I realized that many offices are closed on Friday making late Thursday hours seem a bit more reasonable. Even odder is that nothing really opens till 1:00 on Mondays. Sunday hours involved local businesses filing a law suit to keep from having to open at all on Sundays. Back in America I could run to a store and pick up almost anything I could want 24 hours a day, here you have to do some very careful scheduling to make sure you don't run out of food at home.

I think I have begun to figure out why the store hours seem so strange to me. In the US most businesses want to be open as long as possible and they normally have no trouble finding employees to fill the hours. In the Netherlands it isn't that people don't want to work, the Dutch have a very strong, Calvinist influenced work ethic. The Dutch maintain a very high level of productivity, one of the highest in the world and equal to if not higher than US labor productivity. All of this productivity happens within the shortest average work week in the world. An average Netherlander only works 29.5 hours per week, because of this they also have a slightly lower average annual income than an average American worker, and they are perfectly OK with that.

In America we seem obsessed with income. We want to make more and more money so we can spend more and more money even though all of the hours we work can prevent us from enjoying the things that we purchase. In the Netherlands the average person seems much less obsessed with income than they are with quality of life. If you can live with less, or less expensive things, you can get by with less money which means you can have more time for yourself and your friends and family instead of your boss. In America we like big, flashy, new cars. The Dutch like these cars as well, but they reason that if a €5000 used car will get you to where you need to go then why would you pay €30000 for a flashy new car? In the US we would say, A. because we can, and B. because it is flashy. This isn't the way the Dutch think.

In the Netherlands someone who owns a flashy car or wears expensive clothes is considered a show off and very shallow. Here almost nothing is purchased on credit so if you own somethings it is assumed that you worked all of the hours required to pay for it in full. If you own an expensive car you obviously have no life, spend no time with friends and family, and are probably not very interesting. In the US someone might decide the responsible thing to do instead of buying an expensive car would be to purchase a bicycle and use it for most of their commuting. Then they would go out to a bike shop and purchase a really nice new bike, an expensive helmet, cycling clothes, and all the other accoutrements required to show the rest of the world that you are a responsible cyclist. The Dutch would just laugh at this. They would instead buy the cheapest used bike they could, ride in their daily clothes, and never think about a helmet. Then they would ride the bike home and enjoy being gezellig.

"Gezellig" is a Dutch word that can't really be translated into English (it also can't be pronounced correctly by most of us who speak English as our first language) but it is a descriptive word relating to things that are cozy or comfortable or warm or pleasantly familiar. It is also possibly the single most important word in the Dutch language. Netherlanders seek out gezellig, they cherish gezellig, they value gezellig over almost anything else. Work isn't gezellig but the income it provides can help provide gezellig. After a certain numbers of hours at work though your job starts to provide diminishing returns when it comes to gezellig as it takes away from the time you could be enjoying gezellig things. The Dutch are very concerned with efficiency and have discovered that when it comes to living a full and happy life a 40 hour work week isn't very efficient and certainly isn't very gezellig.

Could Americans ever figure out a way to translate "gezellig"? It seems like the nation that considers itself the most innovative on Earth should be able to find a way to let its people enjoy life.

Sunday, August 11, 2013

Things that are different, so far.

So, I have been living in the Netherlands for about a week now. Long enough to start getting a bit used to things but not so long as to stop noticing things that are different here from the US. If you have spent much time in Europe much of what I will comment on will seem obvious to you, but if you are like me and have never been to Europe or the Netherlands before you may find yourself as surprised as I have been.

First things first, you need to understand that I am living in Tilburg, the 6th largest city in the Netherlands, which has a population of around 200,000. This is not Amsterdam but the Dutch who live outside of Amsterdam will be quick to tell you that their capital city is not a good representation of the rest of their country. Yes, there are a few "coffee shops" here in Tilburg where one can indulge in marijuana but they are far from common place (and no, I have not visited any of them) and while prostitution may be present here I have seen no evidence of it. Again, this is not Amsterdam, this is simply a working class/ university town that does not rely on tourists for its survival.

So what has stood out to me as being different? First off is the food. In the Southern US we love our food spicy and fried. They don't shy away from frying here, but they have a very different idea of what spicy means. Instead they seem to enjoy making most everything sweet. Yesterday we were at a weekly open air market right outside our apartment building and we picked up some sausages that were baked into a croissant like pastry with a curry sauce. The sauce was much less spicy than it was sweet and everywhere you go you see fresh baked, sweet pastries. You can get French fries with a sweet peanut sauce. I have tried paprika flavored Pringle's and they had a bit of sweetness to them, even many of the cheeses are a bit on the sweet side. The Dutch like their food sweet.

They also like it cheap. In general groceries seem about 20% cheaper here than they did in Nashville and the prices in Nashville are rock bottom when compared to a place like New York City. Restaurant prices however seem slightly higher here. I don't even remember seeing a dollar... I mean Euro menu at the local McDonalds. But that's OK because they have the McKroket sandwich which is quite tasty. Drinks, for example soft drinks, are pricey when you eat out. You can easily pay €2 to €2,50 for a coke in a restaurant, but it will probably come in a bottle instead of a paper cup. If it does come in a paper cup you probably won't be dispensing it yourself as is common in the US and even if you do there probably won't be an ice dispenser as most of Europe seems to think that putting ice in a drink will kill either them or you so for safety's sake they just won't do it.

Of course the differences with food don't stop there and I'm not even going to get into the love the Dutch hold for pickled herring. No, I am talking about the inevitable outcome of eating, a visit to the toilet. Many, if not most, toilets in the Netherlands are a bit odd by American standards. First off the toilet in a Dutch home will not be found in the bathroom. The bathroom is used for bathing, the toilet, along with a tiny sink, will be found in the water closet. Once you have located the water closet the real fun begins. Look at an American toilet and you will probably see an open container holding a fair amount of water that serves as a landing, or splashdown point, for human waste. When you look at a Dutch toilet you will probably see a large, relatively dry, expanse of porcelain that angles down into a small reservoir of water at the front edge of the toilet. I have nicknamed this exposed area of porcelain "the observation deck". You see I have no idea why Dutch toilets are designed this way but the end effect is that the product of your efforts are left high and dry and on perfect display. The other effect is that none of the odors are sealed in by water and so elimination becomes a very sensory experience. Not every toilet here is designed this way but it seems the majority in homes, including our home, they are. I am sure there is a good reason for it but I am at a loss as to what that reason may be.

I will end this post on that as I don't want to give you too much to digest at once (pun intended) so check back soon and I am sure I will have more interesting tidbits about living in the Netherlands to share with you.

Saturday, August 3, 2013

An American in Europe

So, contrary to what a few conservatives might think, I am very proud to be an American. I think my country has accomplished many amazing things and is, overall, a pretty great place. Being in Europe, however, has made me realize what it means to be an American outside of America.

Many Americans come to Europe and manage to somehow keep themselves surrounded by other Americans. We haven't had that luxury. Somewhat by choice and somewhat by chance we have found ourselves thrust into the middle of a couple of cultures that we are not, as of yet, really a part of. Before coming here you have an idea of how an American would be received in this situation. You might think that we would be hated, you might think that we would be loved, what we find instead is either indifference or mild curiosity. Being an American here doesn't seem to be any different that being Chinese or Brazilian to the people we are meeting. When we are in areas not frequented by tourists there is at most slight surprise that we would leave the tourist areas where all the signs are in English. When we get the chance to have a conversation with someone in these areas we suddenly learn what it really means to be an American.

In the US I am from Nashville or from Tennessee and both of things carry certain connotations with them. I am a liberal or I am gay or I am white or I am middle class. Here I am none of those things, I am simply an American. Here I am cut from the same stone as Barack Obama and Pat Robertson. I am from New York and LA. I am a cowboy and a robber baron. Gay, liberal, Nashville, none of these things mean anything here, I am simply an American without any asterisks.

This has led me to think that the US, which for years was a great melting pot, has become a very divided place where none of us really are Americans any more, at least until we leave the country. We have stopped being proud of our nation and instead have become proud of our ideologies or lack there of. We have taken sides on everything to such an extent that we have become blind to the things that should be holding us together. The rest of the world still seems to see us as a single entity, why can't we?

Thursday, August 1, 2013

Drinking in Europe

So, for someone who grew up in the Bible Belt the social rules and laws concerning drinking over here in Europe strike me as a bit odd. First off beer here in Berlin and also in the Netherlands is cheaper than bottled water, this is not hyperbole, it is fact. Secondly alcoholic beverages are available every where you go. In the US we expect to see candy at the checkout in grocery stores but here in Berlin you find cigarettes and miniature bottles of liquor. Drinks at a bar are also remarkably cheap by US standards, I think this continent may run on alcohol. Here is where it gets really interesting though, in the time that I have been here, including spending a day at a fair, I haven't seen a single obviously drunk person. Not on the street and not in a bar.
In the US people claim that if we teach sex education in schools our children will become sex fiends. Here nudity and sex are common on TV and sex education is not at all taboo in schools and yet then teen pregnancy rate and std rates are lower than in the US. We raised the drinking age from 18 to 21 in the US but here they seem to have fewer problems with drinking. The Netherlands allows the recreational use of marijuana and they have considerably lower rates of drug use and addiction than we suffer through in America.
You can't say that adopting European ideals concerning these issues would produce the same results in the US, but since what we are currently doing isn't working maybe we should reconsider our tactics?