THE HAGUE--Arranging medical referrals abroad for the Caribbean Netherlands is a complex matter due to logistical challenges that sometimes have to be adapted on a daily basis as a result of last-minute changes at the hospitals to which the patients are sent.
Dutch State Secretary of Public Health, Well-being and Sport VWS Paul Blokhuis wrote this in a letter that he sent to the Second Chamber of the Dutch Parliament earlier this week with regard to the Caribbean Netherlands Health Insurance Office ZVK.
The Second Chamber’s Permanent Committee for Kingdom Relations received a letter from a St. Eustatius resident in December last year and asked Blokhuis for a reaction. Blokhuis thanked the Statia resident for thinking critically and apologised for his late response.
Blokhuis admitted that unfortunately things can go wrong in the complex logistical operation of sending patients from Bonaire, St. Eustatius and Saba abroad for medical treatment or an appointment with a medical specialist.
The tasks of the VWS Ministry were taken care of via the ZVK office in Bonaire until recently. “We have concluded that the communication is not always optimal. That is why we have appointed a team leader for the Windward Islands. Since February, she has been residing temporarily in the Windward Islands,” stated Blokhuis.
According to him, health care in the Caribbean Netherlands has been improved a lot in the past 10 years. “But further improvement is still possible. We do have to look at how we can limit the increase of cost, just as in the Netherlands, to keep care affordable in the long term.”
In his letter, Blokhuis addressed a few matters with regard to the ZVK and the medical referrals about which the Statia resident wrote. He confirmed that students indeed have to pay their medical bills and declare the cost for reimbursement. “From Bonaire, we cannot draw up contracts with all health care providers in the Netherlands and check the medical necessity of the declared cost.”
He explained that considering the geographical position and scale of the Caribbean Netherlands, another care system, different cooperation relations with health care providers and sometimes different coverage was chosen.
He explained that there were also advantages: no premiums are paid in the Caribbean Netherlands and there is no own risk. When a resident/student returns to the Netherlands, access to basic health insurance is guaranteed.
Blokhuis remarked that a comparison of necessary health care cost between the Netherlands and the Caribbean Netherlands was hard to make. One of the reasons is, for example, that part of the cost in the Caribbean Netherlands is medical referrals abroad via air.
He noted that the VWS Ministry has invested a lot in health care in the Caribbean Netherlands since 2010, to eliminate backlogs and to bring health care to a level comparable to that of the Netherlands.
He said a number of health care providers did not have their internal (management) processes completely in order. “The ZVK is working hard to further improve the legitimacy of the health care expenditures.”
Blokhuis assured that the patient was the focal point as much as possible and that this was always considered in decisions that were taken. He announced that talks were ongoing with St. Maarten Medical Center to see how visits to the islands could be improved and could also be introduced via modern techniques, such as consultations via video-conferencing. Furthermore, there is a helicopter on standby 24/7 for medical emergency evacuations.
