The sometimes Kafkaesque bureaucracy of healthcare in The Netherlands

Day 1.

Thankfully, I don’t need to see a doctor very often. But recently, I found myself requiring the opinion of a specialist. So I went to see my doctor and she used the online system to refer me to a healthcare institution in Utrecht. All seemed just fine and dandy up until then. However, the next day I got a call from Utrecht and that’s when the problems began (the following conversations are all rough translations and not verbatim):

Day 2.

Me: “Hello?”

Utrecht: “Good morning, am I speaking with Menzonius?”

Me: “Yes, that’s my name.”

Utrecht: “Excellent, I’m calling because we received a reference from your doctor, is that correct?”

Me: “That’s right, yes.”

Utrecht: Great, we’d like to make an appointment with you. How would June 11 suit you?

Me: ?? (Here I am thinking: WTF?? That’s almost 3 months from now!)

Utrecht: “Hello?”

Me: “Uhhhh, okay… Would it be possible to see someone a bit sooner? It is rather urgent.”

Utrecht: “I’m afraid not, no.”

Me: “Okay, in that case would it be possible to go to one of your other branches, such as in Hilversum, if they can see me sooner?”

Utrecht: “No problem, but we can’t refer you; you have to ask your doctor for another separate referral for that.”

Me: “Rrrrrright…. I’ll do that then. Thanks. (for nothing)

Utrecht: “That’s alright, good day.”

Great. So then I call the doctor again. But I forgot you can only call the practice between 8am—12pm for appointments. Wonderful.

Day 3.

So, the next morning I give the ol’ medicine man a call again. I get the assistant on the other line and I tell her about the issue. She in turn informs me the doc is out on Fridays, but she’ll discuss it with the doctor on Monday.

Day 6.

True to her word, I get a call on Monday and the doctor has agreed to refer me to the branch in Almere which has a waiting list of only one week. She will email me the case number of the online referral via email. I need that number for all correspondence with the healthcare institution. The email will arrive in one or two days. Problem solved, right? Guess again…

Day 9.

One or two days pass by, and still no email. So I call again, and the assistant explains: “Ah, yes, sorry about that—there appears to be some technical problem with the online referral system. We will try again this afternoon and then you will either receive an email, or else I’ll call you.”

Day 10.

No email, no call. Great. So next morning I call again. The assistant informs me: “Sorry about this, but there’s still a big problem with the online referral system. How about we just give you a written referral note from the doctor and you just make an appointment by phoning the specialist you want to see? The doctor is not in today, would it be possible for you to pick up the referral on Monday?”

Looks like I don’t have a choice, so I agree to pick up the note on Monday. In the mean time, I call the general 0900 number for the healthcare institution in question and then the following conversation ensues:

Me: “Good afternoon, I was initially referred to your branch in Utrecht, but because of the incredibly long waiting list I requested my doctor to refer me to Almere. However, the online reference system is giving problems right now, so I will pick up the reference note on Monday. Would it be possible to make an appointment?

0900: “I’m afraid you’ll need to get the reference note first.”

Me: “Uhhh, but I already have a reference note for your branch in Utrecht. And I will get another one on Monday, so I will definitely have a reference by the time I get to see anyone in Almere. In fact, I will have two.

0900: Yes, but the first referral is only valid in Utrecht. We don’t want patients registered in two systems.

Me: ??? (Here I am thinking: What the hell kind of dumb fucking system is that?)

0900: Also, the insurance will give us problems if the date on the referral is after today’s date. And it is also our company policy to only make appointments for patients who already have a referral.

Me: Jesus Christ! Even if it’s only to make the appointment? Even though I will definitely bring a doctor’s reference with me? Even though I technically already have a referral?

0900: Yes, I’m sorry but that’s the way it is.

Me: Right, interesting. I’ll call again on Monday then. Okay, thanks.

0900: Alright, you’re welcome.

Next week, the saga continues on Menzonius.nl: Day 13 and beyond—will Menzonius finally get that appointment? Or will he transform into a bug-like creature? Stay tuned!

 

 

The $PATH of logic

Boy, this is going to be a short post. I recently installed the current stable version of SWI-Prolog, which is a free version of Prolog: the general purpose logic programming language. I installed it on OS X version 10.9.1, but thereupon found that the command line binary is not added to any directory for such binaries that existed in my system’s $PATH variable at the time. (It’s okay to be confused by that sentence.)

So here I now demonstrate my solution to this problem. My reason for sharing this is far less altruistic than you might think: I simply have a short memory and writing it down on my blog is just a convenient way to have access to that information in case I should need it again. But I do hope that perhaps people who have faced the same problem—people so unbelievably desperate for a solution that they would be willing to try *anything*—will also find the information I present here of some use and/or amusement. Probably more the latter than the former.

The solution is trivial and probably not the best way to do it. But the same can be said of the utility of toilet paper, and untold millions use that every day, so there you go. You need to add the path to the SWI-Prolog binary in your $PATH variable. One simply opens a terminal and changes directory into /etc/paths.d. Then you execute sudo nano SWI-Prolog in the terminal (this starts the nano text editor and creates a file called ‘SWI-Prolog’ in your current directory) and add the line /Applications/SWI-Prolog.app/Contents/MacOS. Next, one saves this file by pressing ctrl+x and selecting ‘yes’ when the editor asks for confirmation.

If all went well, you can now start a new SWI-Prolog session within any new terminal window (so first close and re-open your terminal) by simply entering swipl in the command prompt. Live long and prosper!

Gay marriage causes floods, says UK councillor

Every time you have a natural disaster, you always have a few nutty people who claim that the disaster is actually a punishment by God. I usually find that such idiots tend to be confined to more backwards regions of the globe, such as some of the places heavily hit by the 2004 tsunami for example. So it would be a rare occurrence indeed to chance upon such a specimen in the more developed areas of the western hemisphere. But that doesn’t mean it doesn’t happen, take David Silvester for example. Mr Silvester, who appears to be some kind of politician in the UK, also appears to be a staunch proponent of the flood myth. He recently made the statement that the recent flooding of a large part of Britain is related to the legalization of gay marriage.

Fascinating theory! While I’m sure the IPCC would be most interested in dedicating a whole chapter of their next assessment report on the effect of homosexuality on global climatic change, Mr Silvester has in the mean time been suspended by his political party. Initially, his political party supported his right to express his opinion. And I agree, expressing your opinion is mostly a good thing. However, a man’s GOT to know his limitations. So to put it into perspective I will conclude this post with a statement from ‘Dirty Harry’, who is most wise in all matters concerning opinions: