What if ASML Provided Healthcare?

In the previous part, I concluded with the question: what if ASML provided healthcare? A rather unorthodox question, but this is why it’s been on my mind. A warning beforehand: the average Netflix series more pleasant to watch than this piece is to read. But it ends on a hopeful note; that I assure you. Additionally, the next article will be closer to home, as it will focus on our colleagues and what their work demands from them for our fellows and their families.

The Call from Europe

A study by Quelsa (2024) revealed that 74% of our Yes We Can fellows do not return to specialized care (in 2019, this was 72%). This study was conducted among 1,899 fellows (at least one year, up to two years after Yes We Can treatment) who were treated in the clinic. We are incredibly proud of this percentage, which is (significantly) above the Dutch and European averages.

The performance of our 550 colleagues, and the achievements of more than 1,250 families and fellows, have not gone unnoticed in Europe. Each year, we received more and more requests for treatment from families and professionals abroad. Since 2017, we have therefore offered an English-language program at Yes We Can Youth Clinics, also at our beautiful clinic in Hilvarenbeek. But despite that, several countries have been increasingly trying to convince us to expand or even relocate our activities across borders.

Fellows from Texel to Maastricht, from Hong Kong to Stockholm

Fellows from over 50 countries have been treated at Yes We Can in the Netherlands, leading other governments to request whether we could establish ourselves in their countries as well. The first request came from England, but soon after, there were requests from Denmark, Switzerland, the United Arab Emirates, Singapore, Saudi Arabia, Germany, and Sweden.

Although we are confident in our quality, we have never sought to grow just for the sake of it. Our standard response has been: “No, we’re sorry. We still have so much to do in the Netherlands.” And although we still have a lot to do, our answer in the past year has shifted to: “Yes, probably. Even though we still have so much to do in the Netherlands.” I find this not only painful as a Yes We Can member but also just as a Dutch citizen, who sees in his immediate surroundings how many young people are struggling.

Credit where credit is (also) due: Dutch health insurers (VGZ, CZ, Menzis, and Zilveren Kruis) have significantly contributed to the accessibility of Yes We Can Clinics. They still do, for which we are incredibly grateful, especially to Mayke Houben, Nicole Smeets, Tom Wassenaar, and Marieke Verlee (all four from CZ), Erwin Hol and Jelmer van den Akker (both from VGZ), Emile van Doorn and Arnold de Koning (both from Menzis), and Francien Beute (Zilveren Kruis). Numerous healthcare regions and municipalities are also our partners, working alongside the insurers to make much possible for Dutch families.

But simultaneously, it is the central government that makes regulations in the Netherlands increasingly complex. Both healthcare providers and health insurers suffer from this. Just a few examples:

• Annually having to negotiate or tender with dozens of healthcare regions with complex contract and tariff structures. With a government in Luxembourg or international insurers, this is done on a multi-year basis, in a generic contract, applying NZa tariffs and then only monitoring customer satisfaction. People really know very well what works for them.
• Excruciatingly slow spatial permit procedures, while refugee locations receive approval within weeks and ASML gets on the cabinet agenda within a week by threatening to leave the country. This says nothing about the necessity for refugees, which is self-evident, or the importance of ASML to our economy, but it does say something about our lack of awareness that there is also a necessity to expedite good high-specialized healthcare providers.
• Not giving experiential expertise a serious position in the reimbursement system (despite health insurers and healthcare providers standing hand in hand on this), and sometimes deeming professionals with, for example, a sports degree unfit for healthcare, despite proven benefits (living climate research in Leiden and Amsterdam). Let alone examples from Iceland, Sweden, and Denmark where sports are synonymous with mental health and are an integral part of healthcare.
• Of much of the available repressive or closed care in the Netherlands, we all know that it does more harm to the health of young people. For years, there has been talk of a 'reform agenda,' but Professor Harrie Verbon aptly states: “In the Youth Reform Agenda, there is no agreement on the future of the youth care system. At most, there is an agreement on what the challenges are.” A lot of talk, little action.

If bureaucracy has done anything, it has brought insurers and providers closer together. Both experience—each in their own way—the same thing. In short: the Netherlands usually unintentionally makes healthcare more complex, despite all good intentions. Meanwhile, some other governments have realized that they need to ‘unburden’ us so that we can fully focus on helping families, fellows, and colleagues.

Actions 1 and 2

Don't get me wrong: we are not leaving the Netherlands, and I am also the last to say that there isn’t enough money for healthcare or innovation in the Netherlands. After working in Southern Africa for years, you won’t convince me of that anymore. Money is not our problem. There is enough money in the Netherlands; but we don’t spend it effectively due to our bureaucracy. The fear of spending even one euro incorrectly is so great that we often stifle ourselves with complex procedures and accountability mechanisms. Our fear is greater than our trust in good organizations and professionals to truly give them the space and freedom.

Do you know how we built Discovery? It might surprise you. We did something that is not in our nature at all. We had to let go and completely relinquish control for a while. We gave a brilliant Chief Technology Officer from fintech, with an even more brilliant team, all the space to build something with a few principles. We then excelled in ‘the art of doing nothing.’

Am I then really only pessimistic? No, absolutely not. Because there are countless people who, every day—at Yes We Can and in other great places—passionately dedicate themselves to others. As long as they are there, I also believe that new willing politicians and talented civil servants will eventually realize that something drastic needs to change to facilitate organizations that provide good or even excellent care.

Let them take an example from the NHS and several cantons in Switzerland. They have certainly not reached the point where everything is going well: because that takes years. But they have done something much more important that we also teach our fellows with the first 2 of the 10 actions:

Action 1: “We admit that our problem is too big to solve on our own and that our current way of living does not work for this problem.”

Action 2: “We are willing to believe that with the help of others, we can change.”

The fellows are already doing it in Hilvarenbeek. Every day. The governments in London and Bern are now doing it too. Now it’s The Hague’s turn.

So where’s the point about ASML?

The point is: we obviously don’t make unique high-tech lithography machines that are needed across Europe and China. We do something entirely different. My colleagues—with their unconditional dedication, professionalism, and ever-present smile and energy—heal in others, who come from all over the world, what life has broken in them. Despite what it costs them personally.

ASML creates machines that shape the future of the new world.

Yes We Can creates a healthy future for young people who will take this new world forward.

Perhaps we should strive for a time when we no longer separate economic success from social well-being and recognize their mutual importance. That might just be the highest form of progress we can achieve together.