Monday, August 31, 2009
Since they opened up the Health Insurance market here, which they called liberalising the market, this has meant that a public service has been re-designated as a profit making enterprise and the franchiches were up for grabs.
The health insurance has gone up considerably in price and has been cut back even more considerably.
Up to 2005 the basic cost per month was aprox. 30 guilders, for which you got good care, also regular dental checks by the dentist.
And then they turned public companies into private companies and opened up the market and health became a commodity and now we pay 250 Euros each per month and get less than we did previously.
Plus everyone has to pay 150 up front at the beginning of the year.
It is also very frustrating here, a new law the WMO came into force in 2007, up to then local council carried out the governments guidelines which was organised and administrated centrally from The Hague.
Now the new law which administers the provisions for the sick and handicapped is administered locally and has variations depending on location.
Each city and town has the right to specify what they will provide; in Haarlem it is easy to get a hand bike attachment for the wheelchair, but not in Amsterdam.
I applied for one in 2007, on the advice of the ergo therapist by the RCA, after several months where it seemed the outcome would be good; I finally got word that I had lost.
But had I really lost as instead of a nothing I was a going to get the Speedy, the electric scooter as soon as I handed in my scooter.
This was great news as I could not use the scooter as I could no longer walk at all b y the time I was given the scooter.
Had I been given it right away when I needed it I could have had 6 months use of it, as it was it went to the RCA with me when I became an in patient and the scooter sat in the hall and was only used once when I had a test drive in the park.
The WMO is a frustrating law, while the law states what you have a right to mobility aids, what you actually get is a different thing altogether, as it is up to the individual councils.
Sadly it is run on a cost cutting model, so they do not look for the best for you and your situation, instead they will look for something that gives the minimum and is cheap.
This is not a good way to run a support service, it results in strange rules, and for example I had some facts to back up my appeal against the hand bike decision.
I pointed out to them the health benefits of being able to effienctly move yourself around in the wheelchair with a manual hand bike attachment.
I was informed that medical reasons were not grounds for appeal, that they looked at it purely on administrative reasons and I had none so my appeal was dismissed.
At the RCA I also noticed that week after week people were being given the same type of wheelchair, seems one size fitted all.
Obviously they had bought in bulk and were giving them to everyone who needed a wheelchair, even
Though they were big, clumsy and heavy.
Spoke to two people, she unhappy in a chair too heavy for her to move independently in; he with heart problems and asthma had to push her, he had to sit every few meters, which is not possible everywhere in Amsterdam.
Or there would be huge delays getting replacement bits for a wheelchair, met one man at the RCA, who needed new wheel guards so he did not get splattered every time it rained, he had been waiting for a year.
He had many appointments with an advisor from Welzorg and each time the wheel guard was not ok, it would generally not be the right size, eventually a year later he was the proud recipient of a set of cheap plastic wheel guards that kept him dry.
In Amsterdam it is difficult to get about in a wheelchair, the accessibility law means all premises open to the public like shops and cafes and restaurants are accessible.
Here you can still see new premises that have big thresholds and so no way you can get inside without a lot of effort and assistance.
The City Council should refuse shops and other business their operating licence until their premises are accessible to all.
The City Council bought new trams; they spent millions, just before the new law on accessibility came in here in Europe.
The trams do not facilitate smooth access, instead the conductor has to bring out a two small metal ramps and try to get it set up so the prospective wheelchair passenger can roll on.
Sadly the tram stops do not provide enough room for this manoeuvre and tram conductors were endangering their health trying to lift people sideways onto the ramp.
That means that trams are not accessible and if you do manage to get in there is a small space which you share with bicycles and prams.
The Government has done similar with he trains, buying trains that are inaccessible without the assistance of the train conductor.
You have to phone and book in advance inclusive of your return journey and station you will arrive and leave from.
The trains should be accessible now but somehow they have managed to wriggle out of conforming to the law, until they can buy new rolling stock, think aprox. in 2020.
I have noticed that there are alot of incompetent people out there masquerading as people who care and they are frittering away money that was earmarked for mobility aids and adapted housing.
Shame that the people that are good and do put your interests first are not those involved in advising the Council as to what you need.
They are using their skills to help and support people who are vulnerable because of sickness and progressive diseases.
They are the jewels you meet as you progress through the labyrinth that is Social Care.