A surprising European approach to health-care reform. The Netherlands is a liberal country. It has legalized drugs and euthanasia is an accepted social policy. Yet, to solve its health care dilemma of rising costs and inefficiency, it has turned to a health care system that sounds much more like something to come out of the American Enterprise Institute than from a nation in which the Socialist party made the largest gains in the last election. It is opting for private health insurance and competition.

We have heard many arguments that the American health-care system should adopt a typical European style, centrally controlled, single-payer system. The argument is made that such a system would provide a fairness that is now missing in our system. While the European systems were generally begun with the premise that all citizens should have health-care coverage, the problem of rapidly rising costs has plagued every European nation. Unlike what has transpired in the Netherlands, these rising costs have typically led to restraints on the demand for care (co-payments, deductibles, other incremental payments) or on the supply of services (global budgets that limit purchase of equipment by hospitals, gatekeepers to control referrals to specialists, etc.).