Tuesday, February 12, 2008

Ian Williams on Taiwan's Health Care System as a Model

Many of us expats enjoy living here because unlike the dog-eat-dog US where I hail from, Taiwan has is civilized and has a national health care system that is both excellent and affordable. Reporter Ian Williams runs it down, and discusses it in comparison, in a long article in Dissent, featured on his blog. Some of it is a bit off, but on the whole it is good. More importantly, it is yet another example of Taiwan's many success stories, something that the barrage of criticism Taiwanese direct at their own society often misses. Williams opens:

Some years ago in New York I went to hear the Taiwanese health minister describe the country’s new National Health Service. He had just been to visit George W. Bush’s first secretary of health, Tommy Thompson. I could not resist and asked, “While you were in Washington, did you explain to the Republican secretary of health that you’ve introduced a socialized health system?” He looked me squarely in the eyes and said, “You know, it completely slipped my mind!” And well it might. We have heard much tendentious information about the alleged success of Chile’s privatization of social security, but little of the unchallenged efficacy of Taiwan’s health service.

I'd be blogging a bit more today, but chipping the frost off my keyboard takes forever. Brrr.....


TicoExpat said...

Pity CNN -the McDonald's of information/ which had an extensive -meaning long- presentation on this subject, pointed very slantedly that the options abvailable in the US, should it go into universal social care, would be waiting 6 months for surgery, at least, like Canada or England. The Taiwanese model may not be perfect, but its coverage and scope are quite impressive. However, as with all things Taiwanese, good PR does not make it out of the island.

I am still very much in awe with the medical system in the US. Several family members have been brought from the clutches of death after car accidents, one even spent 3 months in a coma and made it -still a bit funny in the head, but so she was originally-. They all paid dearly for the treatments. However, the costs, prevention system and availability could be greately improved.

It is ridiculous to be employed and not being able to afford even basic care. To marry just to have insurance sounds plausible if you are a laborer, but in my thinking, not if you're supposed to be middle class, like a cameraman or photographer. Along with the subprime loan shark debacle, it is a symptom of something very wrong and fishy.

skiingkow said...

Well, the low price for medicine is what impressed me the most about Taiwan's medical system. We have it pretty damn good in Canada, so the fact that you don't have to declare bankruptcy if you get cancer is something I'm accustomed to. Perhaps it's different if you're an American.

However, the level of care that my wife's grandmother received at one of the hospitals in Taiwan was downright criminal. In fact, she paid for it with her life. We took it to the government health department -- with evidence showing the blatant mistreatment she had received, but you can't really do much unless you have money and lots of time.

The bottom line is that the wealthy still receive far better care in Taiwan. And that is nothing to be proud of.

Anonymous said...

Taiwan's health care system is outstanding but still a mystery to about half of the population. It's implementation should probably be credited to the KMT since the old soldiers were the thrust that put it into place.

Deadline Pundit said...

Hi Michael

thanks for your comments and appreciation of what I've been trying to do re Taiwan. I've put a link to your informative site on deadline.pundit. Keep in touch!

Mark said...

The most amazing thing about Taiwan's health program is its affordability. Not only is it dirt cheap to see a doctor or dentist (~3USD), but taxes are also far lower than in the US. Back when I was working in the US, I only got to take home about 60% of my paycheck (after my employer paid half the SS). The medical insurance was terrible, too. Just seeing a dentist for a regular cleaning and checkup cost about 200USD after insurance.

Here, in Taiwan, the most I've had to pay in taxes is about 10%. That includes health insurance. It makes me wonder how the heck the US spends all the taxes it brings in.

Deadline Pundit said...

Interesting comments, but it also depends when you left the US. All systems have their horror stories about doctors - some of the earliest writing in history is about it!
But with the growth of health management organizations, health care in the USA has all the disadvantages of government run systems, in terms of rationing, restrictions on which practitioners you can see and waiting lists. I am sure there is room for improvement in Taiwan, but the shambles of the US system are beyond repair. One friend with a prolapsed womb who was uninsured was told by her doctor to stage a massive bleeding outside the hospital on a day when he was in so that she could be treated as an emergency! She was lucky in her doctor.
Ian Williams

Michael Turton said...

Yeah, I know lots of people who were almost killed or were killed by the system here. Misdiagnoses are really common.

The system is great, though. Dental work is cheap, and all our dentists were trained in the US. My ENT was born there and is fluently bilingual. I think that's another underappreciated aspect of the system -- lots of younger docs have up to date training.

One problem I've noticed is that patient-doctor communication sucks. Docs don't want to inform you or more likely, don't realize what information you need. The service mentality in Taiwan sucks, a consequence of high context cultural practices, I think.

But I'd like to thank Ian for getting Taiwan out there in the world. We need more of that.


Tommy said...

My experience with the health care system in Taiwan was that the meds were cheap and the consultations were cheap. On an average, the quality of the care was decent for what you pay for. The "for what you pay for" is the key here.

I did notice that you could heighten your chances of better service and care depending on your choice of hospital. I often went to the Cathay hospital on Renai only because they had night consultations. However, they function like a factory only, and I was not a fan of the doctors. However, other hospitals were better. The best way is to try several doctors and just keep going to the staff that you have the most confidence in.

There can be no comparison to the [lack of a] US system. Even people like me, who are not versed in the complexities, can see that the state of health care in the US is a disgrace. Book a doctor a month in advance that you can't really choose. Then pay an arm and a leg to see him/her (that's just the premium. the insurance already costs almost as much as your rent). Then wait an hour in the waiting room to see the guy for 10 minutes. Then head to the pharmacy (usually not in the doctor's office) where you pay another high premium for meds that you can only reserve a month at a time. Then repeat the process next month....

Taiwanese don't know how good they have it.

Anonymous said...

Taiwan's dental system was cheap, is cheap and the reason I have hepatitus B.