Getting medical treatment in the Netherlands is hard enough as it is for international students, says Hungarian student Balázs Markos. But if you’re disabled or chronically ill, like he is, and don’t have a job, it’s totally impossible.
Last week, Andra Buciu wrote an op-ed on the difficulty internationals have navigating the Dutch healthcare system. I can completely relate to the situation she described. Let me introduce two other aspects to this topic: chronic illness and disability.
I have written my international human rights law master thesis on the right to health of disabled and chronically ill students in the European Union; therefore, I am able to reflect on this topic from both an academic and a personal viewpoint.
I am an EU student; I have been studying in Groningen since 2018. Until now, I have not had employment in the Netherlands. I have a permanent disability, which makes me wheelchair-bound. Besides this, I have asthma and allergies, which require treatment and prescription medication.
According to Dutch law, international students do not have the opportunity to take out Dutch health insurance. Thus, for EU students, using an European Health Insurance Card (EHIC) is the only option.
If you break a leg, you get emergency treatment, but what if you need weekly physiotherapy?
This card can be requested from your national health insurance provider, and it is supposed to cover the costs of all medical care that becomes necessary during a temporary stay in another EU country. This seems great, but EU law does not define either the concept of ‘necessary care’ or that of ‘temporary stay’.
Some examples can be quite clear: for example, if a Dutch citizen breaks her leg during her one-week holiday in Spain, it is obvious that she can receive emergency treatment in a Spanish hospital using her EHIC card. But what about a Hungarian student who comes to study in Groningen for three years and would need physiotherapy each week due to his disability? Do they fall into the same category?
According to EU law, they do. However, as I have discovered during the interviews I conducted for my master’s thesis, health insurance providers are reluctant to cover expensive treatments received abroad. There is no rule on the maximum coverage; health insurance companies provide as much reimbursement as they see fit. This leads to much uncertainty among students who have long-term health problems and are studying abroad.
As mentioned by Andra Buciu, having a Dutch GP is a precondition for receiving most kinds of treatments in the Netherlands, except perhaps for an absolute emergency. However, Dutch GPs are reluctant to accept applicants without Dutch health insurance. This has already been highlighted in UKrant, and I can also confirm that this is indeed the situation.
No treatment without GP, no GP without health insurance, and no health insurance without a job
A few weeks ago, I tried to register at a GP close to my home, but I got a response that they could not accept me without Dutch health insurance. After this, I attempted to register with a Dutch health insurance company. My application was refused, because I was unable to present a proof of my employment in the Netherlands.
Thus, I am sent from pillar to post: no treatment without GP, no GP without health insurance, and no health insurance without a job. Luckily, I will soon be able to break this impasse, as I will have an employment contract in March. However, this doesn’t alter the fact that I have been staying here for 4.5 years without appropriate medical treatment.
From the interviews conducted for my thesis, and stories appearing in UKrant, it’s become clear to me that I’m not the only one having to deal with this problem. I hope this article will raise awareness, and perhaps also invite readers to think about a feasible solution. We can only bring about change if our voices are heard.
Balázs Markos is a master of international human rights law