It must be said that the controversial debate in the Netherlands is nothing compared to the debate over healthcare in the United States. The Affordable Care Act, also known as ‘Obamacare’, was introduced in 2010 in an attempt to resolve some of the major challenges in the American healthcare system. Previously, there were private health insurance policies that were only affordable for the rich. Due to the large number of uninsured Americans, US healthcare (already the most expensive in the world) faced additional financial burdens, as the healthcare budget is also used for the uninsured who can’t pay for care. The Affordable Care Act provides government-organised private health insurance for everyone, and is aimed at reducing the number of uninsured Americans by at least half (before this law there were about 50 million, roughly 20 percent of the population!).

Remarkably, there is quite a bit of opposition to the measures, mainly from conservative politicians in the Republican camp. They’re working against the implementation of the law in various US states because they fear that the costs to the government will soar and because the idea of compulsory insurance is at odds with their belief that the ‘Freedom of Choice’ is a great thing and should continue in America. Various legal cases have been filed against the law, some even reaching the Supreme Court; the next will be heard on 4 March. If the case is won by the plaintiffs, about eight million people (indeed, half of our population) will lose their insurance, and the premiums for those who remain insured will increase exponentially. This would bring the entire system under further pressure, and could, in the worst case, bring an end to of one of the most social initiatives of the Obama administration. That’s an extra bitter pill to swallow considering that 75% of insured Americans indicated in a poll last summer that they were satisfied with their new insurance.

When I was recently at a conference of American presidents of university medical centres and spoke about the Dutch and German healthcare systems, my American colleagues were not impressed by the severity of our problems. A colleague told me, “Your system will be maintained because it’s based on solidarity, not on the principle of ‘every man for himself and God for us all’, which is the motto in American society.” The comparison struck me because it’s true. Solidarity is the core of our society and should remain so, especially in shaping healthcare.

Based on the idea of solidarity, a good and sustainable balance must be found between government support and the role of insurance companies, resulting in a consensus about the financial impact on our society and on the individual. A complex issue—absolutely—but I’m convinced that we can solve it. After all, that’s what we do in the Netherlands, and have been doing for decades. Personally, when I come back from a visit to the US, I’m always very happy that I live in a country that cherishes solidarity—and that I didn’t need to go to the doctor there.