This is interesting because there is so much conflicting information. On one hand several people mention they received timely inexpensive care in single-payer system and on other hand there are example of people who were told to wait in line for weeks or get denied of their desired treatment option. It appears that Taiwan's system is certainly getting stretched now and they have been putting up new constraints and caps. My main worry is that in single-payer you have zero options. If your "payer" decides to put a new rule (for example, only cover treatment X because Y is too expensive), it applies to you whether you like it or not and there is nothing you can do about it. Further, in single-payer there are virtually no incentives or restrictions on what they would and can do because its a virtual monopoly. For example, government can decide to reduce budget on health care because they must spend more money on defense due to some foreign threat.
How Taiwan transformed its health care system
31–40 of 94 posts
Re: How Taiwan transformed its health care system
#32Culture helps - everyone here wants to be a doctor, lawyer, or engineer. Taiwanese doctors don't get paid in money. They get paid "credits" which have to be exchanged for money based on a parallel financial system. Foreigners here sometimes complain that there's a focus on seeing more patients faster, so there might be a misdiagnosis or a less thorough examination. The fact remains though - it's cheaper to fly here t…
> Taiwanese doctors don't get paid in money.
> They get paid "credits" which have to be exchanged for money based on a parallel financial system.
This is really interesting. Had a quick google and couldn’t find anything. Do you have a link with more details?
Re: How Taiwan transformed its health care system
#33Culture helps - everyone here wants to be a doctor, lawyer, or engineer. Taiwanese doctors don't get paid in money. They get paid "credits" which have to be exchanged for money based on a parallel financial system. Foreigners here sometimes complain that there's a focus on seeing more patients faster, so there might be a misdiagnosis or a less thorough examination. The fact remains though - it's cheaper to fly here t…
Chap I worked with used to fly back to Terhan for his dentist as well as visiting family - said his old dentist was cheaper and better than UK. Just wondering if part of that is simply cost of living difference?
Re: How Taiwan transformed its health care system
#34Taiwan does indeed have world class health care despite having an exceedingly low tax rate by western standards. But lets not overlook the elephant in the room. Taiwan is an island full of thin people who eat rice or noodles at almost every meal. Millions of people still shop primarily at traditional markets and millions of others follow Buddhist diets that would be mocked by western "diet hackers". Only in the past…
Hi there! Taiwanese here. We invented boba (full of sugar and unhealthy), and our cuisine, while delicious, can be incredibly unhealthy. We are actually struggling to confront one of Asia's largest obesity epidemics. I think the notion that we're an island "full of thin people who eat rice or noodles at almost every meal" is not only a problematic and reductionist characterization, it ignores the problems that we fac…
Thanks for contributing, quote from OA
"Finally, it began to institute global budgets — caps on the total amount paid for all care — in the hope of squeezing providers into becoming more efficient."
OK, what happens when a part of the system hits the cap in a given year? Rising obesity -> cancer/blood pressure/type 2 diabetes in a decade or two based on UK experience. In UK we spend a large % of GDP on the NHS but that % can't keep rising forever, so I'm interested in alternatives.
Re: How Taiwan transformed its health care system
#35I had half of my toe nail severed off due to a bathtub mishap. I dint have first aid kit at home and rushed to minute clinic at CVS near my house. They charged my insurance whooping $150 to bandage a wound... I dint have to pay anything, but I felt this was way tooo excessive.
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Re: How Taiwan transformed its health care system
#36This is interesting because there is so much conflicting information. On one hand several people mention they received timely inexpensive care in single-payer system and on other hand there are example of people who were told to wait in line for weeks or get denied of their desired treatment option. It appears that Taiwan's system is certainly getting stretched now and they have been putting up new constraints and ca…
While that's probably true, it's difficult to have a comprehensive individual patient cost comparison because medical issues are so diverse, and some people do indeed consider some issues to not require immediate attention. But I imagine only a financially unhealthy government would strip the health care system's funding for all things that the general population considers a basic requirement. And if your government has financial straits that dire, you're going to have so many problems in all aspects of life, not just health care. What's the point of being healthy if everything else is a living hell? Not saying this is a good argument for or against single payer. I am saying that whether or not single payer should be the system is probably an unimportant question for an insolvent government's populace.
Re: How Taiwan transformed its health care system
#37What are the opportunities for Taiwan healthcare workers to emigrate? Sometimes the surprising quality comes from lack of perspectives for the workers (for example strict visas requirements in contrast to EU free labour movement). Many very good doctors from Central and Eastern Europe emigrated and the quality of healthcare dropped.
When I went to Taiwan in 2009, several people told me that Taiwan exports lots of doctors to China. Here's the only reference I can find right now: http://focustaiwan.tw/news/atod/201403250026.aspx
Re: How Taiwan transformed its health care system
#38Culture helps - everyone here wants to be a doctor, lawyer, or engineer. Taiwanese doctors don't get paid in money. They get paid "credits" which have to be exchanged for money based on a parallel financial system. Foreigners here sometimes complain that there's a focus on seeing more patients faster, so there might be a misdiagnosis or a less thorough examination. The fact remains though - it's cheaper to fly here t…
Chap I worked with used to fly back to Terhan for his dentist as well as visiting family - said his old dentist was cheaper and better than UK. Just wondering if part of that is simply cost of living difference?
Sure. A lot of medicine is pretty much a simple service business, economically. You are paying for the services of a person. These tend to be very locally priced.
But.... Medicine is not really an ordinary market, most places. It's not really a market in the US and Europe, in the sense that prices are set like other services. A big determinant of costs tends to be how well the system works.
Re: How Taiwan transformed its health care system
#39While visiting my in-laws in Taiwan (Taichung City), My son slipped on the floor and busted his head just above the eye. We took him to the ER. He got 7 stitches and occupied an ER bed for 4 hours while the drugs they used to put him under wore off. We paid after we were released. It came out to about $200 US total, without insurance. We got back to Austin a week later and had the stitches removed, which cost us $60,…
When I visited Taiwan, I needed to get some urgent dental care done. I went to a small local clinic, where the dentist spoke good enough english, did great work (including x-rays) and my total uninsured bill was less than my co-pay in the US would have been. It is good AND affordable.
The average American dentist earns $175,000, the median is ~$155,000. What do you propose to do about that to reduce their income considerably to bring down overall costs vs what a dentist in Taiwan earns?
US GDP per capita is nearly three times that of Taiwan, incomes are likewise far higher.
It's equivalent to comparing costs in Switzerland versus Czech and being surprised that Switzerland is so much higher.
Re: How Taiwan transformed its health care system
#40This is interesting because there is so much conflicting information. On one hand several people mention they received timely inexpensive care in single-payer system and on other hand there are example of people who were told to wait in line for weeks or get denied of their desired treatment option. It appears that Taiwan's system is certainly getting stretched now and they have been putting up new constraints and ca…
With most US based insurance being employer based I don't see how the "we only cover x because of y" really is a discriminating function between single payer vs multiple. My ability to choose an employer based on their health care plan is challenging at best. I may be missing something however as I mostly know the US system