4. All together now

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  • role of insurance
  • community feeling
  • basic care is provided for everyone, no difference between poor and rich
  • hospital interiors are basic and simple, rooms are large and offer place for many patienst
  • family takes care of food, washing
  • rich people travel abroad for high service health care
  • creation of a market for care takers


During the first years of the century the costs of health care and the various hospitals have risen enormously. This steep increase in costs of health care made health care almost unaffordable for a large part of the people of Amsterdam. To reduce costs of the health care most 'nice to have' services have been removed. This 'nice to have' service can include services like food, cleaning of clothes, entertainment etc. But these 'nice to have' service can also be new innovations in health care. For some people (the early, wealthy adaptors) these might be 'must have' services but for other people the old fashion health care, meaning without all the new innovations, might be a 'nice to have'. It is known that these new innovations are more expensive during the early adaptors years.

In general hospitals, 90% of all health care related actions are taken care off. More specialised services are done in special hospitals. In the general hospitals only the core product is being offered. The extras can either be bought or organised by the patient (through family or friends). This means that families will take care of the food, washing and other services to the patient. Even the supply of medicine can done by the family or friends. Besides the financial side of this development the large range of cultures and religions in Amsterdam also enables this trend; by taking care of some aspects of the health care yourself (through family or friends) one can create its services more 'custom made' to the patients’ habits, cultures or religion requirements.

The developments in tele-monitoring can also be enabler of this development because e.g. the patients can 'call' or skype a friend, relative or religion member to come by in case of an 'minor' emergency to take care of e.g. give pills, helping to dress etc. If service is require a request is being sent the 'listed' friends; who are at that time close to the hospital.

If these activities are not being taken care of a fine has to be paid to the service provider or hospital.

In and around the hospitals extra services can be bought from local entrepreneurs. Because these services are done by more local service providers; without any expensive overhead they can be offered more cheaply then the facility support of the 'old fashion' hospitals. Additionally, more tailor made service can be offered because of the small and local size of the services.