#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! ^-^