Healthcare in the Netherlands
A 2008 article in the journal "Health Affairs" suggested that the Dutch health system, which combines mandatory universal coverage with competing private health plans, could serve as a model for reform in the US. However,
an assessment of the 2006 Dutch health insurance reforms published in Duke University's "Journal of Health Politics, Policy and Law" in 2008 raised concerns. The analysis found that market-based competition in healthcare may not have the advantages over more publicly based single payer models that were originally envisioned for the reforms:
Emergency medical services in the Netherlands
Emergency medical service in the Netherlands is provided by a number of private carriers, operating under contract to the Dutch government. The system consists of a number of private ambulance companies, each with its own designated service area within one of fifteen service delivery regions, and with standards of operation that are provided by the government contract. All contracts stipulate that the contractor is required to meet all standards published for vehicles, equipment, training, and performance by the Dutch Ambulance Institute. All contracts for EMS in the Netherlands are sent to tender every four years, with the contract being awarded to the most successful applicants. Netherlands law forbids EMS systems to earn any profit; any surplus revenue is required to be directed to additional improvements to the system, including training, equipment, and vehicles. The Dutch system is a rare exception to the rule in Europe, in that it operates on a variation of the Anglo-American model of EMS care, and not on the Franco-German model, followed by the majority of European countries.
The government of the Netherlands contracts for air ambulance service, which is provided by four helicopters, all of which are in service around the clock. These helicopters are strategically located around the country to minimize response times. Air units may perform high-acuity inter-facility transfers, or may also respond to the location where an emergency is occurring, to assist with immediate care or facilitate rapid transport of high-acuity victims.. All air ambulance helicopters are staffed by both nurse and physicians. The primary role of the helicopters is the rapid delivery of the Mobile Medical Team, and transport of the patient by aircraft, while possible, is not the preferred outcome. In some cases, particularly for response to offshore emergencies, the civilian air ambulance system is supplemented by the three helicopters of the Search and Rescue service of the Netherlands Coastguard; using assets provided by the Dutch Navy and Dutch Air Force services. All of these helicopters are transport-capable. Some areas of Holland also receive emergency air ambulance service from helicopters or vehicles based in Belgium and Germany, since these locations are beyond the normal flight range of the Dutch-owned aircraft.