There are a couple other things that were mandated as part of this private insurance competition market—it is all not-for-profit. That doesn’t mean that people aren’t making a living, not-for-profit doesn’t mean that people don’t do it for the wrong reasons, but they have mandates on the way that those insurance companies behave in that there’s no cherry picking. There are little to no copays or out-of-pocket costs. There are very few exemptions and [their system] encourages a lot of intra-company streamlining and efficiency building, kind of proprietary gamesmanship in order to make themselves more competitive in that market. 

What is the greatest lesson you think you learned from the Dutch that could inform how we might structure our health care system in the U.S. moving forward?

TM: The things about [the Dutch] experience that showed how successful they were and things that we should borrow are that they’re very open to looking outside the field of medicine. For example when they borrowed pieces from IT and from the internet, [in the early 2000s] online teaching and learning was still kind of a new thing. They had a lot of sharing and collaborations. Also, look outside your borders, your country borders, your ethnic borders, your language borders, your socioeconomic borders. There are a lot of countries where everyone speaks English, but they might not open their arms to somebody coming in and teaching in English. [The Dutch] are very open to outsiders and outside concepts.

What‘s one thing you love about the Netherlands? What do you miss about living there?

TM: I’d really loved my experience of five years in the Netherlands. I was a newlywed and we had our two children there. Nearly half of the babies in the Netherlands are born at home. We decided to have our kids in the hospital, and I don’t think we paid anything except for my insurance premiums; we didn’t have to pay for anything [extra]. I did break my wrist when I was there. I was thrown off a horse and I didn’t have to pay anything for treatment. And so, my experiences as a patient were very good. 

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