Saturday, 14 April 2012

Depression and insurance, Dutch style

on the wire

Friends and even random acquaintances know that I do enjoy a good chat. A nice way to say I never shut up and once I start rambling, you might fix yourself a cup of tea and get used to the notion it's going to take a while.
Yet today something happened that made me speechless. Whoa, hold and behold! What was that? Virginia speechless? Yes, it happens sometimes, and this time it happened not only because I didn't want my flatmate I definitely lost it and I'm talking to myself (again). I really didn't know what to say.
But first a small digression.

Some days ago I was listening to Leonard Cohen and remembered I read that he began writing "Bird on the wire" while in Greece and how that song related to (his) depression. It made me think about many things that happened recently in my life, first of all coming to terms with the notion that depression is not something an aspirin can cure: it's a constant everyday battle, you take arms against this invisible enemy that hides inside your soul, like a Don Quixote against the windmills (appropriate, given where I'm living, anyway...). Still sometimes you are just not enough, you need help and this help comes in different forms: a friend that understand you and bugs you about it, a friend that understand you and shuts up, a good GP that instead of prescribing you paracetamol and advising you to rest asks you to come back every fortnight or whenever you feel the need of talking about it.

If I am slightly better today, it's also thanks to people like these.
Depression requires a lot of work and help; sometimes the help comes for free, sometime you got to pay (dearly). It's a never ending struggle. I wake up everyday and I don't know how it's going to be, but I've been lucky enough to receive help and to learn how to try to protect myself.

So, this morning I woke up, fix myself a nice cup of coffee and set to read the news online. I shouldn't have, yet I did. And I read this news: for about 10 good minutes I was absolutely speechless.
Then I started swearing in the guise of a sailor in the worse rundown bar in Marseille old town.
The Healthcare Insurance Board issued a report that advises that Dutch suffering for any mental illness produced by work,  bad marriage or death of a loved one should not ask their insurance to cover for the therapy, but pay it by themselves. The board suggests that only mental disorders such as depression or schizophrenia should be reimbursed.
Fair enough, this is a country where everybody claims some days of "burn out" on purpose, because they got not enough public holiday, but what these people are implying is quite dangerous.
The chairman of the board stated that there is a "difference between being sick and not sick" and that insurance should not be paying for care for people who are not sick. And here is the problem. Who should have the last word on whether I am sick or not? A doctor? Or an insurance board?
If you need the tonsillitis to be removed, who do you ask help? A surgeon or the chairman of the insurance board?
The insurances are suggesting you place the knife in their hand, as they know it best.
What they are suggesting is that they hold the call to say who is sick and who is not, not the doctors.
A loss, a bad working environment might just make you feel bad and sick for few days but could also plunge you into a depression that shuts all the lights out of your life and this board is suggesting that if this happens, it's first of all your fault and then it'll be in the hand of one of their employee in a call-center to decide whether they can financially use the money you paid into their accounts or not.

What will be the next step? I can imagine that quite easily: oh you got mesothelioma? Well, it's your fault because you went and worked in the fibre cement and asbestos industry. It's not our fault and we shouldn't pay.
You got involved in a car accident? This should teach you: stay home or walk next time!

So far, I have had very little to do with my Dutch health insurance and I am relieved to think I will have very little to deal with them in the future.
Not that Italy is any better, but no matter what, I still think that any country that still have a national healthcare system should hold it dearly and never ever allow any government or insurance board to take it away from its people.


  1. I understood it differently: anyone with a formal diagnosis of depression, made presumably by a doctor, no matter what the cause was, should be entitled to care payed for by the insurance. But I'm glad I'm not the doctor who should tell the difference between sadness and depression, especially under pressure of insurance companies.

  2. Damn Google authentication! R. Sciascia.

  3. Well, I have to agree with you, V. Sadness, Depression... Most of people would wrap´em together in the same bag telling you to just get over it but never thought on what the goverment would say about it... Silly me: Goverment is made of/by people too, so I won´t expect any different kindness!
    A common friend, Mayrim Sandoval, from London, told me about your blog and I´ve been reading it. I think is decent, straight and, for the love of God, how I laughed about James Bond having a Heineken!!! I don´t read italian, but I promise will do my best.
    I have a blog too,, It´s in spanish, though. Hope you enjoy it if you have the time to take a look.
    Thanks for sharing!

  4. Problem is that the insurance board is already complaining that the standards used by doctors are already too "wide" and take in symptoms and disease that they think shouldn't be allowed. This is just plain dangerous, as they want to be in charge of the formal diagnosis.

    Hello Alex! May told me about your blog and about going to Gordon's (I love that place): I will slowly but surely read your blog, might be the right time to pick up yet once more my rusty Spanish!

  5. Hello, V.
    Are you serious? Gordon´s? For Christ sake, I´d kill to go back to that place! It´s simply great. I think it´s a date, then (Got to tell May too, she´s the one to thank for showing me Gordon´s)!!!
    It´s been a pleasure to read your blog, V. I´m looking forward to see more of it, so I´ll be in touch.
    Thanks for your kind answer.

  6. I am not friends with (and I don't marry), people that don't like Gordon's (V. like that one who said he didn't date girls who read Proust), and those who had been there with me and didn't like it haven't survived to tell the story hahaha. The truth is... Alexis already hates me for taking him out of it just minutes before it became that madness that is Gordon's after 4:30pm on a thursday just to show him briefly Hockney at the RA, and if he didn't kill me on that day its pure kindness... all in all, my hours in Gordon's are some of the best ever! Love you guys :), I just wish you both spent more time in this mad city... If something I hate about London is how transitional the people in it is...

  7. Wow, May... I´ve been called so many ways, but transitional (even if in London) it´s the smash hit of the season!!! Still owe you that pic of us in Southbank Centre, sweetie! XOXO

  8. Well, I'm first of all thankful to Alexis for not killing you May!
    Second, Gordon's can be mad sometimes but I got a date there now! Yeah!

    I got a love/hate/love-you-again/kidding-i-hate-you relationship with London, and its "transionality" (??? well, being transitional) is something I sometimes hate, because people come and go and you don't seem able to hold on anybody. Yet, sometimes I love it because you do have the clear understanding that things won't last so you got to make the most out of them on the very right moment.

  9. How comes we started talking about depression and ended up with (me) killing May or (she) calling me Transitional (smash hit, though) or craving for Gordon´s? (my case, at least) Jeez, I now Know why Goverment won´t give us a miserable pill: they won´t think we´re depressed or whatsoever... They´ll think we´re nuts! (I still hope this blog is not beeing read by any security officer (If so, Sir, I didn´t do it... I didn´t even know Gordon´s a month ago and also, I never said anything about Bond, James Bond, Sir... And... How about a glass of water, please. This Guatanamo thing is pretty warm, Am I right? Is it so humid all year long? No? Well, that´s a relief...)