Wednesday, January 25, 2006

universal vs. luxurious health care

Mid-journey to my vacation in India, and taking in the advantages of the Thai Airways lounge as part of my ~5-hr layover in Bangkok.

While planning, I looked up the CDC's recommendations for travel health in India. Then I decided to find a travel doctor. The folks over at Chung Shan Hospital insisted to Neil that only kids need immunizations, and adults should just take reasonable sanitary precautions. Local Taiwanese scoffed that I, typical American, was being paranoid. I thought I should still try to see a doctor, so while booking an appointment online at my preferred hospital, Taiwan Adventist, I noticed they had a travel medicine clinic. Perfect.

The morning of my appointment, a nurse called to tell me that travel medicine was outside of the usual services covered under health insurances, and would require a registration charge of NT$700. Eek! A big jump from the usual NT$100-200, but still reasonable at about US$20. It's my health, so I decided to go for it.

Boy, was I surprised to find that travel medicine is under the Priority Care Center; I'd heard about the Priority Care Center from well-to-do expats who pay a premium to bypass the waiting in line under the normal national health coverage plan. You certainly get what you pay for. In the chic and comfortable waiting area, I saw nurses patiently speaking in Japanese to a sick Japanese child with his worried Mama, and another nurse speaking Taiwanese to an older gentleman.

I got over half an hour of my doctor's time. She was well prepared with recommendations from both the U.S. and Taiwan CDCs, and discussed with me the potential risks of both disease and side effects from medications. A nurse even went and got my prescription "just in case" travel medicines for me - no standing in line, woo!

Unfortunately, I wasn't able to get a polio booster (recommended by the CDC for all adults) because Taiwan carries only the oral kind (and the risks of infection by immunization are greater than my chances of getting it in India, especially since I was fully immunized as a child) or a typhoid vaccination (none available in the whole of Taiwan). Perhaps there's no stock because the costs of carrying it are too great compared to the endemic risksv relative to the country's public health goals.

This isn't to say that I'm unsatisfied with Taiwan's health care system - I think it's great. There is a lot of waiting and not much hand-holding, and a strong does of patient advocacy is required (doctors are under pressure to see as many patients as possible), but overall I've felt the care I've received to be competent, and most importantly, affordable. As far as I know, it's universal access to adequate healthcare (unlike the U.S.).

Again, my experience goes back to my observations of the U.S. as a land of extremes, with the majority obese and a handful of too-thin celebrities held up as models. Of top-notch medical research and techniques, and a huge number of people unable to afford health insurance. As for me, it's still nice to know that it's also possible to receive the kind of time-intensive, thoughtful care I got back at MIT Medical here in Taiwan.


Anonymous said...

Great blog I hope we can work to build a better health care system as we are in a major crisis and health insurance is a major aspect to many.

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