#6 Universal Health Care

#6 National Health Insurance of Taiwan

If the subject of why I stayed in Taiwan for five years ever comes up, having Universal Health Care has always been a first answer. Fortunately, not because I have needed it too often, but the peace of mind that comes with having full inexpensive(!) coverage sure gives one a different sense of freedom. 

I used to say, (and I still do), that Taiwan's National Health Insurance (NHI) System is the one thing, that if I could, I would take with me wherever I go. 

Health checks at China Medical Hospital on the week of arrival. 

"Taiwan established a system of universal National Health Insurance (NHI) in March, 1995, replacing 13 occupational funds that had covered only about 60% of the population (including military health services), largely covering the population at working age. Coverage was 14%, 77%, and 57% for those aged under 20, 20-64 and 65 year and over respectively.  Today, the NHI covers more than 98% of Taiwan's 23 million population and enrollees enjoy almost free access to healthcare, except for a small co-payment, plus some registration fees that, although not mandatory, are required by most clinics and hospitals."

A working checks and balances.

I was never one to go to the doctor's unless it was absolutely needed, (I was also dreading having to figure out how to explain myself with no skill in the language). So, not until I could barely breath and snot was oozing from my nose, did I finally go through the process of a first appointment.

After checking in, give your NHI card to the nurse and wait for your number to be called. 

My first hospital experience was at Jen-Ai Hospital. After getting in contact with a man named Mark Chen, (recommended by my school) it wasn't so daunting. We made an appointment online, which is the advised way to make most appointments. Once online, pick out your health concern department, if you want to pick the doctor as well that is an option, or go for a time that fits your schedule. Include a small description of your pain, illness, discomfort, etc. and submit. You receive a confirmation with a number and an approximate time you should arrive for your appointment.  Of course only dates and times available are shown. 

While we waited, Mr. Chen answered my twenty-one questions about how the healthcare system worked. A part I hadn't realized was that doctors and physicians agree to not be paid absurdly high salaries (compared to USA). Their lower salaries offsets where the money coming in goes to. Here's a study I found on it. Knowing this, it's easy to see (another reason) why a transition to universal healthcare in the USA would be so difficult. Getting anyone to agree to pay cuts for the benefit of all is just unheard of. 

When it was my turn, I went into the doctor's office, had my visit, then came out to wait for my prescription. Once it's handed over by the nurse, you fill and claim your prescription right there in the hospital. Many times the medicine is covered by NHI completely, other times you'll pay $1-12USD. I have yet to hear of a prescription costing more, unless someone did not have the NHI card. Then I have heard of emergency visits costing just $30-$90USD! As an American, that seems unreal.

Note on Prescription Medication: Instead of one hefty strong pharmaceutical drug, you get a combination of 3-6 lighter dosages of Chinese Medicine.  However, it is more difficult to know what you're taking. ^^ The description are usually in Chinese, and many of the ones I've looked up are not sold in the USA. That seems very odd to me. 

"Established in 1980, China Medical University Hospital was the first hospital in Taiwan to integrate Chinese and Western medicine. JCI-accredited since 2010, China Medical offers eight comprehensive medical specialty centers, including a Stroke Center, Cancer Center, Trauma and Emergency Center, Heart and Vascular Center, Organ Transplantation Center, Neuropsychiatry Center, Kidney Institute, and Preventive Medicine Center."

P H A R M A C I E S
Here, there, everywhere.

Full of all the supplies you could need for your own first aid kit. 

"It is mandatory for all citizens in Taiwan to join NHI except for prisoners or people who have moved out of Taiwan. The coverage rate is around 99%. Taiwanese citizens living overseas who maintain the residence registration in Taiwan are also covered by NHI and are required to pay the preimium. Those who live in other countries often come back to Taiwan for major surgery or annual health checkups. Foreign nationals with legal residence in Taiwan may join NHI through their employers."

You can find more pharmacies in Taiwan than you can find gas stations. 

Pharmacies packed full of things good for your
 health and body, most of it under $10-15USD. 

"Owing to the single insurer system, Taiwan's NHI has one of the lowest administrative costs in the world, typically under 2% of total healthcare spending. Every year the Department of Health negotiates with physicians and hospitals to set the global budget, and this helps keep the cost of the NHI down."

Information taken from National Center of Biotechnology Information. 

My first broken bone and the one time I really needed affordable health insurance. 

I recently learned that Lin Shin Hospital, where I had my surgery (just hours after my scooter accident) is a non-profit organization! 

A small clinic. This one is much more shiny, bright, and white than the usual.  I will admit, the cleanliness of health clinics are at a lower standard than what you'd find in the USA, especially so at the dentist offices.
Inexpensive health coverage > Old buildings with dingy colors.

Whether dentistry, therapy or optometry is needed, their offices are never too far away. 

Once a year, dentists and their team come to the school to check kids teeth.

Postpartum Care Center
I'm not a mother, but I've heard the tales. To be frank, postpartum issues are much more common than we are led to believe.  When I drove past this clinic many months back, with its big shiny windows and hot pink sign, I was so impressed, again, with Taiwan's caring nature towards each other. The common decency they have to take care of themselves without shame or judgment. It shouldn't be so surprising to me, yet it is. 

Ladies, going to the OBGYN is a tad bit different here. You meet with a doctor separately in an office for any questions, concerns, etc. Then you're asked to undress and a curtain separates you from the doc for the duration. You return to the office afterwards to speak again. I did find quite shocking at first to see them take patient's blood right there at the front desk, or have urine samples brought out by hand by the patient, straight from the stall to counter. However, I did find it darling to see so many boyfriends coming with their girlfriends to the gynecologist. ^^ Full blood work, tests, and all the jazz can be done at request. If there is a needed reason, it's covered by health insurance 100%. If you are requesting for tests for your own sake, you pay around $15-20 USD. Contraceptives are 1/5th the price paid for in the USA, and the cost of having a baby is probably 1/10th the cost of what it is in the USA. 

You know there's gotta be some good skin doctors around. 

Don't forget to take care of the smallest ones in your home. ^^  My last apartment had cat hotels and dog groomers on the building's main floor. Along with half a dozen pet shops. I apprently lived in the pet lovers and Thai food lovers nook of Taichung.  

It's encouraged to keep a healthy brain, too! ^^

This post is throwing some heat at my home country's health care system rather than solely praising Taiwan's. But as many of us know, it is a real problem in the USA and it doesn't seem to be looking up anytime soon. 

Having affordable healthcare IS possible. Wanting people, even strangers to be taken care of, to not live in pain, disease or illness should be the normal. Drowning in debt, losing a job, skipping out on a much needed doctor's visit simply because of the cost should not be acceptable, not in a first world country. 

 The Taiwanese NHI card is mandatory for it's citizens, just like a license is in the USA. The Taiwanese have it whether they are employed or not. Old or young, pre-existing conditions, or none, does not matter. I will truly miss Taiwan's hospitality. 

To end on a positive note for my home country, here's an IOWA man who believes in health care for all.  

Thanks for reading! ^-^ 

#7 Transportation

Bike rides through a beautiful city. Taipei Dec. 2017

First experience as a scooter gang. Kenting August 2013.

In Taichung city, much like any city that hosts millions of people, you can easily flag down a taxi to get you anywhere you need to go. Starting the meter at $3USD (this hasn't changed in five years by more than half a dollar), a longer journey of 7km / 25 min will run you about $10-12 USD. Most people seem to have scooters, or take the city buses which also include the BRT (Bus Rapid Transit) line, now known as the blue line and runs as bus #300. 

The BRT coming into Taichung train station. The now Blue Line has it's own lane which runs from Taichung Main Station out to Providence University 17.1K (10.6M)
With an 'Easy' card riding the BRT or a bus is free for the first 12* kilometers! 

The new train station built behind the old one. 

Taichung, now the second largest city in Taiwan as of July 2017, will also soon have an MRT (subway metro) consisting of one line. 

An intersections before Taichung Main Station. You can see the train line and the soon to be MRT line above it. 

We also have UBikes in the city. Once your easy card is registered you can also ride and use these bikes for free up to a certain amount of time. I see these in use quiet a lot, and I have enjoyed getting them with friends in these years. ^^ 

Scooters

Scooters are one of the highlights to living in Taiwan for nearly every foreigner I've met. Hop on, hop off, take it up the mountains, ride it across the city, weave in between traffic, get lost, find someplace new, or enjoy the open air of a coastal town or an impromtu ride through the city as a passenger is always a good choice too! But BE CAREFUL! Plenty of people, including myself have been in scooter accidents. (Plenty have not at well.) So take your time, (but don't hesitate), know your surroundings, be alert, and never forget your helmet! 

*Another tip, don't get off on the left side of a scooter to avoid giving yourself a 'Taiwan tattoo.'

My mentee giving me my first scooter ride, end of June 2013.

Most of the time used scooters can be bought for around 300-500USD. Regular maintenance is needed of course, but scooter shops are always within walking distance in the city and the costs are always incredibly low compared to home countries. "Labor costs" don't really seem to be a thing here as far as I've experienced. 

Taiwan does drive on the same side of the road as in the United States. However, when driving  in the city, do not make a right on red. To turn left you must do what we call "boxing." (See above image). Cars have a left turning lane, but for scooters, you must cross the intersections and wait in a 'box' for the next green light, then proceed forward.  

Very common for families, friends, boyfriends and girlfriends to be seen scooting around the city. It's also common to see babies, multiple children, and even dogs on for a scooter ride. I once saw five grown boys on one scooter! 

Not sure if this is a good idea. ^^

Buses

Taking a bus costs nickels and dimes for those with the time.  Photo cred: Jessie Y

In my first couple of years, taking the bus to nearby cities for day trips seemed to go hand in hand with a good weekend. Ranging from $2-12USD you can get anywhere up and down the west coast of Taiwan and into the mountains by bus.  

The cost is inexpensive, however, travelling by bus does take a larger chuck of your time than using the HSR or paying for your own taxi. But, unless the distance is quite far, the extra time isn't so bad.

In the city, I had never used the local buses much (always my scooter) until my accident this past March, which led to a broken arm. Since then I have taken local buses to school daily, as well as many other places. If you have the patience and you've planned the time, the buses are CLEAN, convenient, FREE, and much safer. 

Field Trips on the School Bus!

Buses in front of Kaohsiung's Zuoying (HSR) Station.
To get any further south than Kaohsiung, one must bus.

Taichung Traffic in Harmony

TRA 

Also true for the TRA, Taiwan Railways Administration, costs dollars to travel the circumfreance of Taiwan.  Train lines do not cross through the mighty mountains of isla formosa. 

High Speed Rail

In the most recent years, opting for the HSR (high speed rail) for weekend travels is usually the go-to. 

Photo Cred

Taiwan's bullet train is world class traveling for around $15-$30 USD. Having used Japan's JR bullet train in Feb. 2016, it is easy to see where Taiwan had based their own system from. However, the price for a trip across Japan is quadruple what is paid for on a trip across Taiwan. The Taiwan HSR has just 12 stations running along Taiwan's west coast from Taipei in the North to Kaohsiung in the South.  

Electric Scooters

G O G O R O S 
Founded in 2011;  "GOGORO is a Taiwan- based venture-backed company that develops and sells electric scooters and battery swapping infrastructure." Taiwan's innovative character is, again, spectacular and makes me proud to call this island my home. Companies are often thinking to the future, and how to do better. I've seen a good amount of GOGOROS taking to the roads. I was so excited when I saw a battery charging station recently, and knew more were to come! 
 Here's an article about Taiwan's plan to set up 3,310 stations by 2022!

Electric scooter on Green Island. CNY 2014. 

Garabage and Recycling Trucks

Taiwan's garbage trucks take to the streets playing Beethoven's Fur Elise. 
Photo cred: Chris W.

The less seen, but just as important, compost trucks!

Almost unbelieveable to me, Taiwan once was nicknamed 'Garbage Island.' No longer true, Taiwan now has one of the most efficient recycling systems in place. Wo Ai Ni, Taiwan! 

E-Gate, B****es

Once a legal 'alien' resident, you can get registered with E-Gate at the airport.
From there on, while traveling in and out of the country, your ID card is scanned, your photo is taken, and BAM! You're through. Truly one of the greatest feelings while traveling has been walking right past hundreds of people waiting in line and walking right through those clear glass doors. (Not to mention how insanely nice everyone is at the airports.)

The affordably accessible, pricise, and sanitary public transportation of Taiwan is top notch. Not to mention the joys of riding a scooter, and the excitement of future electric scooters (and cars) taking over Taiwan. 

While I didn't mention much on cars, there are plenty of them. I am always surprised with the amount of high-quality, name-brand cars I see in the city, (considering the roads are always conjested) even seeing a Tesla on the road. Having said that, all of the people and required transportation to get us from point A to B to C, does cause for an awful amount of air pollution. This (is usually why we're wearing masks) is the number one thing I won't miss about Taiwan. 

Thanks for reading! - K 

#8 Cultural Festivals & Traditions

Born in the Year of the Snake

It is easily recognizable that the culture of Taiwan has not been forgotten.  Its ties to China and Japan (having ruled from 1895-1945) is still very much a part of the island's traditions. And wonderfully still, their roots to aboriginal tribes are still existing. Temples can be found seemingly around every corner and their beauty has never faltered. 

Visit to an area still flourishing in aboriginal tribes and traditions.  January 2014

Temple in Changhua

Guishan or Turtle Island is the only active volcanic island  part of Taiwan.
 
Taoism and Buddhism is the majority belief system in Taiwan.

A B O R I G I N A L    T R I B E S 

L U K A N G 

Chinese New Year  

What I enjoy most about the culture of Taiwan are the festivals celebrated for the holidays throughout the entire island, and much of Asia, all based on the calendar of the moon. With these holidays comes old folk tales, beliefs, superstitions, and stories prevalently yet subtlely passed down the generations. 

The new year begins with the first day of the new moon, somewhere between January 20- February 20.  It lasts for 16 days ending with the Lantern Festival. Red envelopes are given to children by their elders, as well as they are often given by companies to employees. Each day has a special purpose, such as a day to visit temples, relatives, and friends, to stay home, to worship Gods or to drive away ghosts. Dragon and lion dances are often in the streets, as well as burning of incense, candles, or firecrackers lit off. The seventh day translates to 'Human Day' and is considered to be the birthday of ordinary men. 

When I moved to Taiwan in 2013, it was the Year of the Snake, but my first Chinese New Year celebration was for the Year of the Horse. It was spent with five friends in a mini van around the southern part of the island, enjoying island music and true Taiwanese home-stays. I have now lived here during the Year of the Goat, Monkey, Rooster, and I will leave during the Year of the Dog. 2019 will be the Year of the Pig, the 12th animal in the 12-year cycle. 

Year of the Goat!

In 2015, the Year of the Goat, Taiching was the host city for the large lantern festival that takes place every year. While you can still find celebrations in nearly every city, one is chosen for the featured celebrations. 

Boracay, Philippines CNY 2016

As this is our biggest break of the school year, I, along with most of the other English teachers here, fly out of the country during CNY. More than likely the country we are going to is also celebrating. I've been in Japan, Philippines, even Australia, all who celebrated Chinese New Year during this time.

Somewhere in Australia. 

Why set off firecrackers during CNY? The Legend of Nian

Lantern Festival 

Pingxi Lantern Festival 2017

Gina & I in Hong Kong for birthday weekend & Lantern Festival (end of CNY). Feb. 2014. 

The Lantern Festival lands on the 15th day of the first lunar month, essentially the night of a full moon. This festival is usually in February or early March. During my first year it happened to land on the 14th, Valentine's Day. My 25th was on the 15th, so I was in Hong Kong instead of Taiwan. It wasn't until 2017 when I finally went to see the REAL lantern festival, like the ones seen in Thailand or Tangled. This unforgettable lantern liftoff can be found near Shifen and Juifen known as Pingxi Lantern Festival. 

During the day, before facing the drowning crowds, we joined the hundreds, if not thousands of others, who were painting and lifting off our own lanterns. Each color represent a different kind of luck to bring to your life. Red for good health, yellow for wealth, orange for good luck, pink for love, purple for intelligence, peach for a happy marriage, white for a bright future, green for a good promotion, light blue for work/career. 

J U I F E N
The prettiest little town in Taiwan. 

Mazu Festivals in Dajia and Chiayi

Here in Taiwan there are some notable festivals for Mazu that take place in Dajia, Miaoli, and many other parts of Taiwan. 

Mazu is the indigenous goddess of the sea, said to protect fishermen and sailors.

Mazu is usually seen with two guardian generals known as "With-the-Wind Ear" and "Thousand-Miles Eyes." These protectors are usually represented as fierce demons, Eyes as green with one horn and Ears red with two horns. The story says that Mazu conquered and subdued these two, turning them into her own loyal guardians. 

Kelly and I at Mazu festival- 2013

Young men painted and dressed as Ba Jia Jiang (eight generals).

Ghost money burnt for Gods at peak of religious ritual.
Other times burnt for ancestors in the afterlife and to return good fortune.

Fireworks and dances between guardians to scare off bad spirits following believers. 

Fun Fact: Woman are not to enter any temples when on their period. This was also true in Indonesia and Myanmar where woman were not even allowed into some holy areas.

Randomly came across while traveling through Chiayi.

> Wang Yeh Boat Burning Festival in Donggong <
Happens every three years, a very unique Taoist Tradition in Taiwan. 

Tomb Sweeping Day / Children's Day
15th day after Spring Equinox 

The cutest little man enjoying cotton candy.

Tomb Sweeping Day is the resemblance of a Chinese Memorial Day. A day to visit the tombs of your ancestors to clean the grave site, pray, and more than likely burn ghost money, also known as joss paper. 

The date for International Children's Day varies in countries all over the world. In Taiwan, it is designated on April 4. It was canceled as a public holiday in 2000, but reinstated in 2011. The US does not have an assigned Children's Day such as we do with Mother's Day or Father's Day. However, Taiwan does not have it's own Mother's Day and has adopted the date we use in the US. Father's day is 8/8. 'Ba' is 8, 'baba' is father, therefore you have the date 8/8. 

The Yoyoban Koala's Class after whipping up some cotton candy. Children's Day 2017
Every year students get a gift from the school and we all get a four day weekend. 

Spring Break on the Beach 2014
The biggest beach party in Taiwan happens over this long weekend the first week in April. 

Last Spring Break- April 2017

Dragon Boat Festival
5th day of the 5th lunar month

Fishing boat of Lanyu's (Orchid Island) Tao people. 
I spent 2015 and 2016 Dragon Boat weekends in Lanyu diving, more on that beautiful island later. 

The Xiaoban Polar Bears getting ready to make zongzi, a special sticky rice wrapped in bamboo leaves. June 2018

NOT MY PHOTO
While I have gone to watch the dragon boat races in the hot summer solstice sun in Kaohsiung once. I usually spend this long weekend in June doing my own favorite hobby in the water, scuba diving.  

Ghost Festival
15th day of the seventh lunar month

The biggest restriction during Ghost Month is to NOT go swimming. So on the last weekend before Ghost Month the beaches are packed with all those getting their last bit of fun in the ocean.  Ghost Month runs for the entire seventh lunar month and is believed to be when ghosts and spirits of ancestors can visit the living. The 'hungry ghosts are released to the world in search of food, money, entertainment, etc.' Other beliefs, or superstitions, that I have heard and seen during Ghost Month; Don't whistle at night; Don't turn your head around if someone pats you on the shoulder; Don't kill insects in your home; and Don't hang clothes outside to dry.  

A great group of Taiwanese teachers took half the English teachers
down to Kenting before Ghost Month, early August 2013. 

Mid- Autumn Festival
15th day of the eighth lunar month

Pomelo, the huge citrus fruit of the Mid-Autumn Festival. Considered to be the Moon Goddess Chang'e's favorite fruit.  In Chinese the name for Pomelo, 'you zi,' also has the meaning of 'prayer for a son.' Therefore putting the pomelo peelings on your head signifies a prayer for the youth in your family.  

 Singapore during the Mid-Autumn Festival in September 2016

The Mid-Autumn Festival wouldn't be the same
without days-long BBQs and Moon Cakes.

Double 9th Day 

Wuchang Temple in Jiji that collapsed after the 9/21/99 earthquake, the strongest one of the century.

Largest Buddhist Memorial in Taiwan - Fo Guang Shan

Christmas in Taipei 2017

Dragon and Tiger Pagodas in Kaohsiung with my cousin Jessica; May 2018

Other well known superstitions in Taiwan:
Don't write another persons name in red; wishes them severe injury or even death.

Don't point at the moon; disrespectful to Moon Goddess and your ear will be cut.

Don't pick up red envelope on the street; a man who does this will need to take a ghost bride.

Four is an unlucky number as it's name in Mandarin sounds like the word for death.

Mole hair is a sign of luck and longevity; I've often seen this on men.

Don't stick your chopsticks into bowl, lay them across, resembles incense in prayer.

Knock on a hotel door before entering so the ghosts will know to leave. 

And my favorite, was hearing a story of a mother-in-law who put a shovel under the bed of her daughter-in-law, in hopes she would become pregnant with a boy, and she did!

Thank for reading! - K