21 ms·

How Taiwan transformed its health care system

177 points by Osiris30 9y ago

gbacon 9y ago
Taiwan has a growing physician shortage … This does not seem like a positive lesson.
cilea 9y ago
Taiwan's health care system is quite comprehensive, coverage includes annual eye examination, teeth cleaning, etc. And, I don't remember paying much for it. People usually go straight to the hospital instead of visiting their family doctors. Most checkups (e.g. X-ray, blood check) are done at the hospital; no need to do mulitple trips. I actually prefer Taiwan's system over Canada's. The thing is, Taiwan's system is relatively newer (the same with their subway). It is difficult to compare.
- geomark 9y ago
  Are these hospitals private or public? The experiences posted in this thread are very similar to my experiences in Thailand at private hospitals which are really nice world class facilities with mostly very good doctors. The public hospitals, however, tend to be way over subscribed and quite poor quality in service and facilities. I'm wondering if there is a private versus public hospital divide in Taiwan.
  - itsZero 9y ago
    Both. The best hospital is a public one and tons of smaller or local hospitals run by both private (usually non-profits) or public. I think the smaller public one do suffer from resource shortage but fair service and quality are still expected and available. (but i live mostly in the city, I do imagine remote area would have some problems)
mc32 9y ago
>Today, most hospitals in Taiwan remain privately owned, mostly nonprofit. Most physicians are still either salaried or self-employed in practices. What they didn't mention, is that often med students get their studies paid by one of the hospitals and then are tied to that hospital up to 7-ish years at depressed salaries --which is likely contributing to the shortage. >Taiwan, in contrast, revamped its top to bottom. Sorry, "its" what? Copy editors, please.
- xtony 9y ago
  >Sorry, "its" what? Copy editors, please. Imagine the sentence "Alice tinkers with her health care system. Bob revamped his." It's the same concept, but with "its" as the pronoun.
  - mc32 9y ago
    Sure, but I expect the NYT to use native Eng speakers who understand that "its" does not work that way. It's just sloppy of them.
    - temp 9y ago
      >that "its" does not work that way. Can you expand on what the mistake is?
      - mc32 9y ago
        It's missing the antecedent. So for this to make sense in Eng it should read: Taiwan, in contrast, revamped its [own|healthcare|something] top to bottom. Otherwise it looks like "Taiwan, in contrast, revamped its [top] [to [the] bottom]."
        temp 9y ago
        >It's missing the antecedent. So for this to make sense in Eng it should read: It's not missing the antecedent, it's near the end of the previous sentence, just like the other person you replied to said. Singapore, which we wrote about in October, tinkers with its health care system all the time. Taiwan, in contrast, revamped its top to bottom. The its clearly refers to health care system from the previous sentence.
peterburkimsher 9y ago
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 to have a wisdom tooth removed (without insurance) than the same operation would cost in Switzerland or the US. There isn't much resentment of medical tourism either - so, you're all welcome to visit!
- godzillabrennus 9y ago
  If they offer English speaking “tour guides” I bet it’d take off.
- ImaCake 9y ago
  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.
  - cknight 9y ago
    Yeah, pros and cons. GP visits are subsidised a set amount by the govt down here, and while for some doctors that means squeezing in as many visits as possible to get volume, for others it just means they get $X from the government and charge the patient an extra $Y for each visit. Many are happy to pay a premium.
  - nerdponx 9y ago
    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 kinds visits available: quick visits and check ups, and diagnostic visits. The first can be over in 10 minutes, the latter should last a solid hour. I'm starting to wonder if "diagnostician" should be a separate specialization. Then I could make an appointment specifically to go see the diagnostician, and not bother the general practitioner, who is evidently too busy to spend more than 15 minutes diagnosing something.
dustinmoorenet 9y ago
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, with insurance. Our kid's doctor, who removed the stitches, said they were beautifully done. Taiwan's healthcare system is not perfect, but at least I don't have to worry about it. It is good AND affordable.
- diziet 9y ago
  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.
  - adventured 9y ago
    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.
    - diziet 9y ago
      I would be very fine paying 3x the rate of Taiwan as the uninsured rate for dentistry. I understand that the cost of labor is different.
    - mtanski 9y ago
      Price controls is a dirty term we refuse to talk about in the good 'ol USA. Most other healthcare systems in the world with low prices have some kind of combination of it when it comes to drugs and procedures performed. The AMA has been fighting any kind of single payer system for 50 years now. They know that a single payer system will result in some kind of price controls. On one hand you understand their point of view (maximizibf their income well being) and on the other hand you understand the issue with that for all of society. Having said that it's not just the income of doctor. Healthcare administration is expensive in the USA. Many doctors offices spend a non insignificant amount of money on just the billing, collection, insurance administration. The health insurance system as we naturally ended up with sucks up a non insignificant amount of money out of the system. It also leads to these weird distortions where every insured procedure is discounted to the insurance agency like 75%... But not if you deal direct. Additionally, operational insurance (malpractice indurance) is another non-insignificant contributor. Our culture and our legal system ensure that many doctors practices will pay a multiple of a practitioners salary in malpractice and related salary. If we want cheaper healthcare all of these need to be addressed one way or another. I am not hopeful that we can escape this local maxima that we're stuck in. Every attempt at change will be meet with fierce opposition from the current status quo.
arcticbull 9y ago
I was visiting Taiwan a few years ago, and one of my friends busted open his lip. We went to the ER in Taipei (without insurance) and they saw him within an hour or so, prescribed some antibiotics, filled the prescription on site and sent him on his way. Total bill was under $20USD all in.
whatyoucantsay 9y ago
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 generation has it really begun adopting, and suffering the effects of, western eating habits. If Taiwanese people ate like Americans and drove everywhere, their health care system would have become bankrupt years ago.
- 35bge57dtjku 9y ago
  That's quite a claim.
- wisty 9y ago
  Taiwan has an obesity rate of >20%. Not quite 35% or whatever the USA is, but still kinda high.
  - Feniks 9y ago
    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?
    - dghughes 9y ago
      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 https://www.youtube.com/watch?v=bGYs4KS_djg
- kevinjcliao 9y ago
  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 face (an epidemic of obesity and an aging population.) [1]http://www.taipeitimes.com/News/editorials/archives/2016/04/26/2003644828 http://www.taipeitimes.com/News/editorials/archives/2016/04/...
anonymous_fun 9y ago
My Taiwanese relatives and wife see the US healthcare system as a big PITA, and from what I have seen of both sides, I agree. Insurance in the US is no guarantee you will get healthcare, will not go broke because of it, or die waiting for it.
Scottieli 9y ago
H. Spectrum is a startup incubator/accelerator focusing on the healthcare sector. Our vision is to boost the entrepreneur community in Asia. Taiwan based. check it here:https://www.linkedin.com/company/10795282/ https://www.linkedin.com/company/10795282/ Join our mailing list Never miss an update:https://www.ylhspectrum.com/ https://www.ylhspectrum.com/
polskibus 9y ago
What 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.
- gurkendoktor 9y ago
  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 http://focustaiwan.tw/news/atod/201403250026.aspx
- evanslify 9y ago
  This exists, but not much. As a matter of fact, many healthcare workers (especially registered nurses) work very, very long hours and get way less paid than they do in other countries. Also I would expect quality of surgeries would drop in future years due to lawsuit or lack of trust between doctor/nurse-families of patient causing doctors/nurses quitting.
ram_rar 9y ago
I 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.
- deleted 9y ago
  [deleted]
sytelus 9y ago
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.
- PakG1 9y ago
  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.
- yellow_postit 9y ago
  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
  - sytelus 9y ago
gurkendoktor 9y ago
For balance, this is a good summary of the issues that Taiwan's NHI system faces: https://english.cw.com.tw/article/article.action?id=1662 https://english.cw.com.tw/article/article.action?id=1662 It matches the complaints I've heard from several nurses quite well. Idiots with a harmless common cold clog hospital waiting rooms just because it's cheap and convenient. Not just doctors, but also nurses are underpaid and will jump ship if they can.
- calcifer 9y ago
  Indeed. I prefer the Dutch system. Here, if you go to a hospital without a) being sent there in an ambulance via a 112 call or b) being referred by your GP ("huisart") insurance won't cover anything. It works wonders for keeping idiots from emergency rooms.
aero_sm1th 9y ago
Taiwan, and ergo Singapore, have an ideal health care system.
- Avshalom 9y ago
  ergo is definitely not the word you want there.
dba7dba 9y ago
If anyone is interested in getting to know about healthcare system in a neighboring Asian nation, South Korea, here's an article you may enjoy. http://askakorean.blogspot.com/2010/01/healthcare-system-in-korea.html http://askakorean.blogspot.com/2010/01/healthcare-system-in-... It seems to be an efficiently run program.
ilamont 9y ago
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.
known 9y ago
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.
jklepatch 9y ago
I live and work in Taiwan. A tooth cleansing is about 7 usd, with insurance. X ray is 30 usd. In France, my country, a tooth cleansing is closer to 60 usd, and a x ray is closer to 70 usd. I guess in the US its even more. Super satisfied with Taiwan healthcare system!
chiefalchemist 9y ago
> "Taiwan has done a great job at treating many communicable diseases, but more chronic conditions are on the rise. These include cancer and cardiovascular and cerebrovascular disease, all of which are expensive to treat." It's foolish to keep talking about healthcare without talking about (personal) health (including diet and lifestyle). Reforming the healthcare system of a relatively young and healthy society is relatively easy (read: doable). On the other hand, "fixing" a healthcare system of a country (e.g., USA) that's aging and more importantly fond of "acquiring" preventable conditions (e.g., obesity, type 2 diabetes, etc.) and you will always be going sideways. Yes, there is room for improvement in the USA. But that's still not going to fix the disgusting amount of resources wasted on the preventables. If healthcare is going to be a right then personal health is the responsibility that must be paired with this right. Thus far the USA isn't interested in the discussion of the latter.
replicatorblog 9y ago
My daughter was diagnosed with Leukemia, spent 10 weeks in a top-notch hospital, got stellar around the clock attention from the best docs in the world for two years, and a limitless supply of chemotherapy and drugs to treat the side effects. Grand total for 24 months of the best care in the world? $8,000 in deductibles. I don't doubt that other healthcare systems are well run, but after my family's ordeal, I came away pretty impressed with our system. Treating cancer for less than the price of a well-worn car is pretty darn impressive.
pixelbill 9y ago
So as an update to my previous post, I've booked a trip to Taiwan. I will be there for a month from Feb 6th-March5th. Could anyone recommend a dentist/oral surgeon around Daxi/Taipei? I am staying there with my friend in Daxi. I can travel too, but I am not 100% certain on the transit system in Taiwan (he lives in a rural area as well, but can probably give me a ride or I can rent a scooter). I would ideally like to get a few dental implants (I am missing 7 teeth in total) during my first week there, so I have a few weeks to heal before my flight back. One tooth will need to come out in the near future and I am missing both teeth around it, so I think an implant would be ideal (molar).

177 points by Osiris30 9y ago

Taiwan has a growing physician shortage … This does not seem like a positive lesson.

Taiwan's health care system is quite comprehensive, coverage includes annual eye examination, teeth cleaning, etc. And, I don't remember paying much for it. People usually go straight to the hospital instead of visiting their family doctors. Most checkups (e.g. X-ray, blood check) are done at the hospital; no need to do mulitple trips. I actually prefer Taiwan's system over Canada's. The thing is, Taiwan's system is relatively newer (the same with their subway). It is difficult to compare.

geomark 9y ago
Are these hospitals private or public? The experiences posted in this thread are very similar to my experiences in Thailand at private hospitals which are really nice world class facilities with mostly very good doctors. The public hospitals, however, tend to be way over subscribed and quite poor quality in service and facilities. I'm wondering if there is a private versus public hospital divide in Taiwan.
- itsZero 9y ago
  Both. The best hospital is a public one and tons of smaller or local hospitals run by both private (usually non-profits) or public. I think the smaller public one do suffer from resource shortage but fair service and quality are still expected and available. (but i live mostly in the city, I do imagine remote area would have some problems)

mc32 9y ago

>Today, most hospitals in Taiwan remain privately owned, mostly nonprofit. Most physicians are still either salaried or self-employed in practices. What they didn't mention, is that often med students get their studies paid by one of the hospitals and then are tied to that hospital up to 7-ish years at depressed salaries --which is likely contributing to the shortage. >Taiwan, in contrast, revamped its top to bottom. Sorry, "its" what? Copy editors, please.

xtony 9y ago
>Sorry, "its" what? Copy editors, please. Imagine the sentence "Alice tinkers with her health care system. Bob revamped his." It's the same concept, but with "its" as the pronoun.
- mc32 9y ago
  Sure, but I expect the NYT to use native Eng speakers who understand that "its" does not work that way. It's just sloppy of them.
  - temp 9y ago
    >that "its" does not work that way. Can you expand on what the mistake is?
    - mc32 9y ago
      It's missing the antecedent. So for this to make sense in Eng it should read: Taiwan, in contrast, revamped its [own|healthcare|something] top to bottom. Otherwise it looks like "Taiwan, in contrast, revamped its [top] [to [the] bottom]."
      - temp 9y ago
        >It's missing the antecedent. So for this to make sense in Eng it should read: It's not missing the antecedent, it's near the end of the previous sentence, just like the other person you replied to said. Singapore, which we wrote about in October, tinkers with its health care system all the time. Taiwan, in contrast, revamped its top to bottom. The its clearly refers to health care system from the previous sentence.

peterburkimsher 9y ago

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 to have a wisdom tooth removed (without insurance) than the same operation would cost in Switzerland or the US. There isn't much resentment of medical tourism either - so, you're all welcome to visit!

godzillabrennus 9y ago
If they offer English speaking “tour guides” I bet it’d take off.
ImaCake 9y ago
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.
- cknight 9y ago
  Yeah, pros and cons. GP visits are subsidised a set amount by the govt down here, and while for some doctors that means squeezing in as many visits as possible to get volume, for others it just means they get $X from the government and charge the patient an extra $Y for each visit. Many are happy to pay a premium.
- nerdponx 9y ago
  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 kinds visits available: quick visits and check ups, and diagnostic visits. The first can be over in 10 minutes, the latter should last a solid hour. I'm starting to wonder if "diagnostician" should be a separate specialization. Then I could make an appointment specifically to go see the diagnostician, and not bother the general practitioner, who is evidently too busy to spend more than 15 minutes diagnosing something.

dustinmoorenet 9y ago

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, with insurance. Our kid's doctor, who removed the stitches, said they were beautifully done. Taiwan's healthcare system is not perfect, but at least I don't have to worry about it. It is good AND affordable.

diziet 9y ago
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.
- adventured 9y ago
  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.
  - diziet 9y ago
    I would be very fine paying 3x the rate of Taiwan as the uninsured rate for dentistry. I understand that the cost of labor is different.
  - mtanski 9y ago
    Price controls is a dirty term we refuse to talk about in the good 'ol USA. Most other healthcare systems in the world with low prices have some kind of combination of it when it comes to drugs and procedures performed. The AMA has been fighting any kind of single payer system for 50 years now. They know that a single payer system will result in some kind of price controls. On one hand you understand their point of view (maximizibf their income well being) and on the other hand you understand the issue with that for all of society. Having said that it's not just the income of doctor. Healthcare administration is expensive in the USA. Many doctors offices spend a non insignificant amount of money on just the billing, collection, insurance administration. The health insurance system as we naturally ended up with sucks up a non insignificant amount of money out of the system. It also leads to these weird distortions where every insured procedure is discounted to the insurance agency like 75%... But not if you deal direct. Additionally, operational insurance (malpractice indurance) is another non-insignificant contributor. Our culture and our legal system ensure that many doctors practices will pay a multiple of a practitioners salary in malpractice and related salary. If we want cheaper healthcare all of these need to be addressed one way or another. I am not hopeful that we can escape this local maxima that we're stuck in. Every attempt at change will be meet with fierce opposition from the current status quo.

arcticbull 9y ago

I was visiting Taiwan a few years ago, and one of my friends busted open his lip. We went to the ER in Taipei (without insurance) and they saw him within an hour or so, prescribed some antibiotics, filled the prescription on site and sent him on his way. Total bill was under $20USD all in.

whatyoucantsay 9y ago

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 generation has it really begun adopting, and suffering the effects of, western eating habits. If Taiwanese people ate like Americans and drove everywhere, their health care system would have become bankrupt years ago.

35bge57dtjku 9y ago
That's quite a claim.
wisty 9y ago
Taiwan has an obesity rate of >20%. Not quite 35% or whatever the USA is, but still kinda high.
- Feniks 9y ago
  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?
  - dghughes 9y ago
    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 https://www.youtube.com/watch?v=bGYs4KS_djg
kevinjcliao 9y ago
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 face (an epidemic of obesity and an aging population.) [1]http://www.taipeitimes.com/News/editorials/archives/2016/04/26/2003644828 http://www.taipeitimes.com/News/editorials/archives/2016/04/...

anonymous_fun 9y ago

My Taiwanese relatives and wife see the US healthcare system as a big PITA, and from what I have seen of both sides, I agree. Insurance in the US is no guarantee you will get healthcare, will not go broke because of it, or die waiting for it.

Scottieli 9y ago

H. Spectrum is a startup incubator/accelerator focusing on the healthcare sector. Our vision is to boost the entrepreneur community in Asia. Taiwan based. check it here:https://www.linkedin.com/company/10795282/ https://www.linkedin.com/company/10795282/ Join our mailing list Never miss an update:https://www.ylhspectrum.com/ https://www.ylhspectrum.com/

polskibus 9y ago

What 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.

gurkendoktor 9y ago
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 http://focustaiwan.tw/news/atod/201403250026.aspx
evanslify 9y ago
This exists, but not much. As a matter of fact, many healthcare workers (especially registered nurses) work very, very long hours and get way less paid than they do in other countries. Also I would expect quality of surgeries would drop in future years due to lawsuit or lack of trust between doctor/nurse-families of patient causing doctors/nurses quitting.

ram_rar 9y ago

I 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.

deleted 9y ago
[deleted]

sytelus 9y ago

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.

PakG1 9y ago
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.
yellow_postit 9y ago
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
- sytelus 9y ago

gurkendoktor 9y ago

For balance, this is a good summary of the issues that Taiwan's NHI system faces: https://english.cw.com.tw/article/article.action?id=1662 https://english.cw.com.tw/article/article.action?id=1662 It matches the complaints I've heard from several nurses quite well. Idiots with a harmless common cold clog hospital waiting rooms just because it's cheap and convenient. Not just doctors, but also nurses are underpaid and will jump ship if they can.

calcifer 9y ago
Indeed. I prefer the Dutch system. Here, if you go to a hospital without a) being sent there in an ambulance via a 112 call or b) being referred by your GP ("huisart") insurance won't cover anything. It works wonders for keeping idiots from emergency rooms.

aero_sm1th 9y ago

Taiwan, and ergo Singapore, have an ideal health care system.

Avshalom 9y ago
ergo is definitely not the word you want there.

dba7dba 9y ago

If anyone is interested in getting to know about healthcare system in a neighboring Asian nation, South Korea, here's an article you may enjoy. http://askakorean.blogspot.com/2010/01/healthcare-system-in-korea.html http://askakorean.blogspot.com/2010/01/healthcare-system-in-... It seems to be an efficiently run program.

ilamont 9y ago

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.

known 9y ago

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.

jklepatch 9y ago

I live and work in Taiwan. A tooth cleansing is about 7 usd, with insurance. X ray is 30 usd. In France, my country, a tooth cleansing is closer to 60 usd, and a x ray is closer to 70 usd. I guess in the US its even more. Super satisfied with Taiwan healthcare system!

chiefalchemist 9y ago

> "Taiwan has done a great job at treating many communicable diseases, but more chronic conditions are on the rise. These include cancer and cardiovascular and cerebrovascular disease, all of which are expensive to treat." It's foolish to keep talking about healthcare without talking about (personal) health (including diet and lifestyle). Reforming the healthcare system of a relatively young and healthy society is relatively easy (read: doable). On the other hand, "fixing" a healthcare system of a country (e.g., USA) that's aging and more importantly fond of "acquiring" preventable conditions (e.g., obesity, type 2 diabetes, etc.) and you will always be going sideways. Yes, there is room for improvement in the USA. But that's still not going to fix the disgusting amount of resources wasted on the preventables. If healthcare is going to be a right then personal health is the responsibility that must be paired with this right. Thus far the USA isn't interested in the discussion of the latter.

replicatorblog 9y ago

My daughter was diagnosed with Leukemia, spent 10 weeks in a top-notch hospital, got stellar around the clock attention from the best docs in the world for two years, and a limitless supply of chemotherapy and drugs to treat the side effects. Grand total for 24 months of the best care in the world? $8,000 in deductibles. I don't doubt that other healthcare systems are well run, but after my family's ordeal, I came away pretty impressed with our system. Treating cancer for less than the price of a well-worn car is pretty darn impressive.

pixelbill 9y ago

So as an update to my previous post, I've booked a trip to Taiwan. I will be there for a month from Feb 6th-March5th. Could anyone recommend a dentist/oral surgeon around Daxi/Taipei? I am staying there with my friend in Daxi. I can travel too, but I am not 100% certain on the transit system in Taiwan (he lives in a rural area as well, but can probably give me a ride or I can rent a scooter). I would ideally like to get a few dental implants (I am missing 7 teeth in total) during my first week there, so I have a few weeks to heal before my flight back. One tooth will need to come out in the near future and I am missing both teeth around it, so I think an implant would be ideal (molar).