Some elements of health care in the Netherlands, according to James Kennedy, an American who teaches Dutch history at the University of Amsterdam.

-- Residents may buy extra coverage for such procedures as cosmetic surgery, alternative medicine, even speech therapy. Kennedy said that together, he and his wife pay about $360 a month, including orthodontia coverage for their children.

-- Income taxes are high, with brackets of 52 percent, 42 percent and 32 percent, but children under 18 get basic care for free.

-- A special tax is levied for a separate fund for catastrophic care. Anyone needing care for more than a year is transferred to that fund. This year that tax may go up 20 percent, Kennedy said, due to the bad economy.

-- Doctors' and nurses’ salaries are capped, and hospitals are forced to make cuts, perhaps even of specialists, when revenue drops.

-- Waiting lists can be a problem in Europe, Kennedy said.