In the context of the furor over U.S. health care and the danger of extending coverage to illegal aliens, I thought I'd share my recent experience with the health care sytem in Taiwan.
I came down with a case of the flu--not awful, but unpleasant: sore throat, sneezing, minor ear infection, overall fatigue and even-more-than-usual crankiness. (My wife pointed out the last item.)
The next day, I went to a small, private ENT clinic that has a good reputation. Appointments aren't necessary, but, since I didn't bother to make one, I had to wait a while--maybe 20 minutes. When I got in to see the doctor, he gave me a thorough examination--asked about my medical history, schedule, sleep and eating habits, peered into the relevant orifices, checked my temperature, listened to my heart and lungs, the usual. I had a couple of questions, which he answered in detail.
As most clinics in Taiwan have an in-house pharmacy, after the consultation I waited about five minutes for my medication. Now, here's the best part of health care in Taiwan: for routine medical care, the flat fee for an examination plus medication is $4.50. Yes, that's U.S. dollars. Great, huh? (In case you're wondering, it's great for the Taiwanese, too; the cost of living in Taipei is about the same as in a mid-American city.)But there was just one problem: when I checked my wallet, I discovered that my national health insurance card was missing.
Uh-oh.
Sure, all citizens and residents here have excellent, almost-free health care. But what if a casual interloper, as I now appeared to be, wanted try to sponge off the system? The receptionist apologized, explaining that she understood my predicament, but, as an undocumented foreigner, I'd have to pay a very high fee. Nearly cringing in emarrassment (and I nearly cringing in fear), she laid the bill on the counter.
$15. Fifteen U.S. dollars. Thta's the flat fee for the ininsured. (But, she explained, if I find or replace my insurance card and bring it by the clinic within a week, I can get the excess $11.50 refunded.)
Fifteen dollar medical care for an alien, legal or illegal. For anyone. How is that possible? As my Taiwanese wife, a bit impatient with the silly question, explained: You're a human being, aren't you? They're doctors, aren't they? How could they turn you away just because you don't have a card?
TIP:
Enter the amount, and click "Tip" to submit!
Julie Tarp
C.K. Dexter Haven
john blumenthal
Robin Sneed
moveovermommy
nanatehay
Salon.com
Comments
Rolling--Yes, I'm an American, but I've lived in several other countries, which gives a bit of perspective. Taiwan has actually been considered a "developed" country for the last 20 years or so, so they do have some resources. But if they can do things like affordable, universal health care, what's stopping the richest nation on the planet?
Annette--It is impressive. I could have been a tourist, or an illegal alien--they didn't even ask for any ID. Of course, it seems a little less miraculous when you consider the billions in inflated costs the U.S. is paying to companies like Halliburton and Blackwater in Iraq. It's just a matter of priorities.
That is all.
Verbal--Thanks!
Ren--But this wouldn't be so shocking to a German or a Swede. Of all the "developed world," only the U.S. doesn't take care of its own people, much less others.
Ms. Tai--Thank you.
austin--That's how it works here, of course. I and every other working person pay a little every month, and the government makes up the rest. I think the racism factor you metioned is part of the historical problem, but not the whole story.
Aric--Indeed.
C.K.--She may be wise, but it's just common sense to people here. As it should be in the U.S..
Trudge1964--You may be housebroken, but my 2 sons aren't. I'll put you in with them. Hope you don't mind crying and baby poo.
Sao Kay--Thanks!
12 MILLION who already are here and millions more that will come will cross the border for free heath care. Does Taiwan have this problem? Doubt it. For that matter does Canada have that problem. No.
And guess what, we don't turn away people either do we. And further more they wont pay $15 dollars, they will pay nothing if they have nothing.
Ah and did it cross your mind why the person told you it would be "expensive"? Maybe in her mind it IS expensive Maybe because 15 US bucks may be nothing to you, but that comes to over 450 TWD. So there are two points there. One, how much is 450 TWD mean to the average local and 2nd, however much it means, they are charging triple for not being insured.
So can you elaborate on the average income of a local, how you came to get a card. What does that cost and what your exact status is there. Lets just please have the full explanation. Also I would not expert you to be turned away, but what if it was $100 or even $200.
Why should it not be. IS $100 an excessive burden on you. So why would it be inhumane for them to make you pay a $100 assuming you are an alien not paying in to their tax system? Why should you get it cheap or free if you can afford it. S0 what if you have one less steak dinner out on the town in trade for treatment?
Is that evil?
But then I still don't know what 4.50 or 15 or 100 US means there.
Maybe the 450TWD is a lot relative to local income.
And your grandiose statement about being a human being is so heartwarming. You say it as if 99% of Americans don't feel the same way. They is no large amount of people in the country saying all humans shouldn't get health care. We are debating HOW it will be administered. Maybe what you should be taking away from Taiwan
I cant remember as it was many years ago. It wa abotu what I would expect a dentist here to charge to put some temp. cement stuff over a tooth that a crown came off. Maybe it would have been free for a local. I have no idea. It never crossed my mind if they have national health care or not. What crossed my mind is that I going to have t pay for it and I did. Big deal.
1) I DO have insurance. I work and am a resident here. But the people at the clinic had no way of knowing that. Now do you get it?
2) Taiwan DOES have a major problem with illegal immigration. In fact, a HIGHER percentage of the population in Taiwan is illegal than in the U.S. Hundreds of thousand of Filipinos, Indonesians and Vietnamese work illegally here for the same reason that Mexicans and Central Americans want to work in the U.S.--much higher pay than at home, even for menial labor. They get health care at the price I mentioned.
3) People DO cross the border into Canada to get health care. They're called U.S. citizens.
4) 450 Taiwan dollars (US$15) is only "expensive" relative to how much people usually pay for health care here. It's still a very low price. Think of how much $15 would be to a person working in a small town in, say, North Dakota or Louisiana; it's about the same to people here. Not a lot.
4) You ask, why shouldn't they ask me to pay $100 or $200 if I'm not contributing to their system? They COULD, of course, but the point is, they DON'T.
5) The "heartwarming" words were my wife's, not mine.
6) If, as you say, 99% of Americans feel the same way, then they should make it happen.
7. I've never been to New Zealand.
A doctor's visit in the US is roughly $125 without insurance (though there are subsidized clinics where anyone can go for less) - if you have insurance, your co-pay is about $35. So the difference between insured and uninsured is roughly equal to that offered in Taiwan. I know you said you got a prescription, too. But since we don't know what it was, the comparison would be irrelevant.
If you had simply posted an article stating that food was inexpensive in Taiwan, do you think people would have jumped on it as evidence of the USs inability to manage food costs?
In general the cost of living in Taipei is similar to that in a smaller town in the U.S.; I'm going to make a minor edit to the post to make sure this is clear.
Al-- Yes, & quite a few Canadians, Brits, Aussies, Germans and others, as well.
The result of the study? Our Medicare system is what they found worked the best--and just took our model and expanded it to the entire country. (See excerpt and site below.)
Thanks for your post--I always love a good irony, even though I'm the butt of the joke.
"JC: How did you decide on that model - the single payer? Why did you go in that direction?
MC: Well, we sent our people around the world to learn their programs, including the United States. Actually, the program is modeled after Medicare. And there are so many similarities - other than that our program covers all of the population, and Medicare covers only the elderly. It seems the way to go to have social insurance…" http://www.pnhp.org/news/2009/april/jonathan_cohn_interv.php