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How Taiwan transformed its health care system

nytimes.com

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Re: How Taiwan transformed its health care system

#61

Post by Feniks »

Symbiote wrote: post #60
sytelus wrote: post #44

Earlier quoted context omitted.

If you have good top tier employer, chances are that you have pretty good insurance. Medical insurance is actually a criteria for lot of people for which employers to work for. This however probably applies to more skilled workers who have such choices. In single-payer, your employer no longer provides insurance. So everyone gets same plan and you are stuck with it.

A top tier employer in Europe may still offer private health care insurance. When my father had cancer treatment, he sometimes asked for the public hospital (shared ward, less lonely when he was feeling OK but had to spend days in a bed) and other times the private hospital (doctors and nurses had more time, but the treatment was the same and he had a private room).

Cultural difference. In my country everyone gets the same standard of healthcare. If you think you think you deserve special treatment just because you're rich you can fly to the US or Singapore. Strangely enough most rich people don't.

Re: How Taiwan transformed its health care system

#62

Post by Feniks »

wisty wrote: post #23
whatyoucantsay wrote: post #15

Taiwan 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…

Taiwan has an obesity rate of >20%. Not quite 35% or whatever the USA is, but still kinda high.

Actually obesity in the US is the norm now.

Preventive healthcare should be pushed more. But remember when Michelle Obama said kids should eat more vegetables?

Re: How Taiwan transformed its health care system

#63

Post by peterburkimsher »

netsharc wrote: post #43
xwvvvvwx wrote: post #32

Earlier quoted context omitted.

> 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?

Maybe they get paid with blockchain-based currency. (I kid..) Maybe he means doctors get paid with status, and if you're a doctor you get better rates for loans.

A blockchain-based currency would be cool, and not totally different to the current system.

All I know is what a medical student at church told me - I'll have to confirm later. But I know that it's not payment as status - the doctors' salaries are set in a parallel currency, which has a changing exchange rate with real NTD. I'll find out and reply.

Re: How Taiwan transformed its health care system

#64

Post by peterburkimsher »

xwvvvvwx wrote: post #32
peterburkimsher wrote: post #12

Culture 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?

Ok, I found out that what I heard about was the balance insurance premium, which adjusted from 4.25% to 4.55% to 5.17%. But I also think I heard that it affects things like years to work to pay off student debt, and retirement. So I think there's more to it. As I remember, it sounded like a parallel currency where doctors fees are tightly regulated, and these "exchange rates" determine their actual salary. But maybe this is my financial ignorance showing.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3405348/

Re: How Taiwan transformed its health care system

#65

Post by kaitai »

ImaCake wrote: post #19
peterburkimsher wrote: post #12

Culture 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…

I have encounted free general practice doctor places in Australia that operate on seeing as many patients as possible. Basically useless if you have a difficult to diagnose problem, but very useful for getting a referal, a script for a pill, or antibiotics.

Isn't that how all non-Veterans Administration medical care in the US works? Genuinely curious -- my understanding is that almost all medical care profit in the US is driven by volume of procedures, and even non-profit care is reimbursed by insurance companies according to procedures.

Re: How Taiwan transformed its health care system

#66

Post by kaitai »

nerdponx wrote: post #52
ImaCake wrote: post #19

Earlier quoted context omitted.

I have encounted free general practice doctor places in Australia that operate on seeing as many patients as possible. Basically useless if you have a difficult to diagnose problem, but very useful for getting a referal, a script for a pill, or antibiotics.

This is how many GP offices work in the USA as well, especially in urban areas or offices associated with hospitals. Unless you already know what kind of specialist you need to go see, and you can afford to go see the right one (might involve multiple visits to multiple specialists), you might literally never get help for a chronic problem that is not obvious on a differential diagnosis. There really needs to be two…

This would only work if there were a mechanism to pay for diagnosis.

Internal medicine specialists are supposed to be "diagnosticians," as you envision it -- they have more training than general practitioners if they're internal medicine specialists. But they're one of the lower-paid specialties, in part because it's easy to charge for a stent or injection but in the US the act of diagnosing a problem doesn't really have a code.

Re: How Taiwan transformed its health care system

#69

Post by Avshalom »

dustinmoorenet wrote: post #13

While 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,…

While 200 USD is certainly cheap by comparison to the US costs, it's still not affordable for a lot of people in this country.

Re: How Taiwan transformed its health care system

#70

Post by taway20171214 »

Avshalom wrote: post #69
dustinmoorenet wrote: post #13

While 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,…

While 200 USD is certainly cheap by comparison to the US costs, it's still not affordable for a lot of people in this country.

here, i'll tell you why you're getting downvoted. the problem with what you're saying is you can apply it to literally any price point. in other words, it's a meaningless statement.

$100 or $10 are certainly cheap, but is not affordable for a lot of people in this country either. there are points in my life when i couldn't spare $10 or even $5. it might happen again if something bad happens.

in fact you could probably go down all the way to $1, or a fraction thereof. what about the single working mom who needs that $1 to ride the bus or the homeless person who uses the coin-op restroom? there's plenty of them out there, and they can't afford it.

at the end of the day, $200 for a foreigner, uninsured, to receive prompt attention, stitches and a short hospital stay with drugs, is cheap. the world is not a fair place but this isn't what should be worrying us.

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