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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

#71

Post by ilamont »

A couple of anecdotes to share.

My wife went back to her hometown in southern Taiwan a few years ago to help take care of her ailing father. One day while at the hospital she saw a tour bus pull up, and forty tourists from mainland China disembark. Their tour of the local sites included a checkup and some tests by the doctors in the hospital. Works out well for them and the hospital, which is not nearly as busy as the facilities in Taipei.

People clogging up emergency care facilities with common colds and minor ailments is common (as noted by others on this thread). There are several negative side effects including patients expecting to be prescribed something even if it's not warranted. If it's antibiotics, that's a problem because people can build resistance to antibiotics. I also believe there can be a kind of assembly-line mentality taking over among the staff at some busy facilities, with doctors spending only a few minutes with each patient. This can unfortunately lead to truly serious cases being overlooked.

For chronic conditions, the quality of care varies quite a bit. One complaint I've heard several times is sometimes there is no coordination between specialists -- it's up to the patient or family members to reach out and make appointments and communicate test results and the conclusions of other doctors. Lots of things can go wrong, and I fear some patients fall between the cracks.

Dental care can be very good and very inexpensive - my dentist here in the U.S. has complemented the skills of the dentists back in Taiwan who put in crowns years ago.

Re: How Taiwan transformed its health care system

#72

Post by peterburkimsher »

LammyL wrote: post #25
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…

How much does it cost to get wisdom teeth removed in the US and in Taiwan? My dentist in Toronto charges around $400 CAD per tooth for extractions, and that’s with full general anesthesia. The price is the same here with private insurance and without.

$5 USD (150 NTD) with insurance at a clinic, up to 400 NTD at a hospital.

Compared to over $400 USD insured in the US.

The cheapest SFOTPE flights cost $468.

It might not work out cheaper for you, depending on your insurance plan, but it should be thought of as a serious option for all non-emergency operations.

http://michaelturton.blogspot.tw/2007/04/life-among-toothles...

Re: How Taiwan transformed its health care system

#73

Post by known »

Q.

How much do people have to pay?

A.

If you’re employed, your employer pays 60 percent of your premium. The employee pays 30 percent, and the government subsidizes 10 percent. The government fully subsidizes the premiums for the poor and gives partial subsidies to veterans, the self-employed and farmers.

Q.

How much is the typical premium?

A.

The total insurance premium for employed workers is 4.6 percent of wages. That’s much lower than in the United States, where the average is between 12 and 20 percent of wages for those who are covered by their employers.

Re: How Taiwan transformed its health care system

#74

Post by brobinson »

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,…

It's good and affordable until 2020 which is when the current (second) iteration is projected to go bankrupt. We shall see what happens after that.

https://house.ettoday.net/news/803652?t=%E4%BA%8C%E4%BB%A3%E...

I did enjoy getting an x-ray (ankle injury) + evaluation + a week of painkillers for $27 USD without insurance, though. I can only imagine what it would have cost in the US.

Re: How Taiwan transformed its health care system

#75

Post by criddell »

LammyL wrote: post #25
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…

How much does it cost to get wisdom teeth removed in the US and in Taiwan? My dentist in Toronto charges around $400 CAD per tooth for extractions, and that’s with full general anesthesia. The price is the same here with private insurance and without.

I have a missing tooth and I'm getting an implant to replace it. Last week I had the post installed. It took about an hour and cost $4200. Insurance covered only the pain meds.

After that's healed, I have to get a replacement tooth mounted on the post and that's another $2000ish. I believe my dental plan will cover $1000 of that.

I don't understand how an implant can cost $4000. It was an hour of time in a dentist office. It seems about an order of magnitude too much. FWIW, I had two estimates and that was the lower one.

Re: How Taiwan transformed its health care system

#76

Post by Feniks »

sytelus wrote: post #31

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 ca…

Well its not the government who decides what is covered or not. Most countries have special boards with doctors who decide what is covered by the basic mandatory health care insurance plan.

But at the end of the day society has to decide whether or not healthcare for everyone is something worth spending money on. And that's were the US fails imo: no sense of a shared community.

Re: How Taiwan transformed its health care system

#77

Post by dghughes »

Feniks wrote: post #62
wisty wrote: post #23

Earlier quoted context omitted.

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?

If they know what a vegetable is.

Jamie Oliver did a show in the US and kids didn't even know what some vegetables were. Jamie showed them potatoes, tomatoes, carrots they may as well been alien the kids didn't have a clue. https://www.youtube.com/watch?v=bGYs4KS_djg

Re: How Taiwan transformed its health care system

#79

Post by Symbiote »

Feniks wrote: post #61
Symbiote wrote: post #60

Earlier quoted context omitted.

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.

There is private health care in the UK and Germany. Presumably others, but not all EU countries.

Re: How Taiwan transformed its health care system

#80

Post by dustinmoorenet »

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.

People in Taiwan have the option of paying for insurance, which would make the costs even lower.
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