We are all aware that Americans spend more on healthcare than any other country in the world. But how much more?
According to an American student recounting his ER visit in a Taiwanese hospital, Americans often face financial hardships when they visit the doctor. We live in a country that professes to be the finest in the world, yet one emergency trip to the hospital may quickly bankrupt someone.
Kevin Bozeat, a 25-year-old student at the time, kept this information in mind when he became unwell while studying in Taiwan and had to go to the hospital. He didn’t have insurance and had no clue what it would cost him. He described his encounter in a now-viral Facebook post titled “The Horrors of Socialized Medicine: A Firsthand Experience.”
It began with a stomachache.
Bozeat’s tummy started to hurt. He went home to relax without giving it any thought. Then he began vomiting uncontrollably, unable to even keep water down. “My symptoms showed no signs of abating,” the doctor stated. “At this point, I had to seek medical treatment; I knew I had to go to the hospital.”
“I wanted to avoid it,” he explained. “I had no idea how different Taiwanese hospitals would be, whether I would be able to find an English-speaking doctor, or what it would cost me (my US health insurance has lapsed, and I don’t qualify for Taiwanese NHI).”
Taiwan’s National Health Insurance (NHI) is a single-payer system that provides coverage to all Taiwanese residents. Foreigners can participate in the system immediately after acquiring a work visa or after six months of residency in the nation. As a student, Bozeat hadn’t been there long enough to be eligible.
But he didn’t have to worry.
Bozeat’s total hospital fee was a fraction of what many insured Americans spend for emergency treatment.
And it’s not like he got subpar service for his money.
“My Taiwanese roommate called a taxi and took me to the ER at NTU Hospital,” Bozeat said. An English-speaking nurse promptly checked me in. Within 20 minutes, I received IV fluids and antiemetics. They ran blood tests and performed an ultrasound to rule out gallstones or appendicitis. From there, I was diagnosed with a severe case of acute viral gastroenteritis (often known as stomach flu). After about 3 hours on an IV, I started to feel a little better; my nausea went away, and my stomach settled down.”
Bozeat was discharged with a prescription for antiemetics and pain medicine, and he was back to normal within a few days. Most of us would begin to panic as we waited for our medical bills to arrive. However, Bozeat was pleasantly surprised:
“The price for the ER visit was $80.00. Eighty. American. Dollars. The payment must be made out of pocket. Total cost. There are no discounts. No insurance. This was at one of Taiwan’s premier hospitals. And if I had NHI, the cost would have been far lower. Without insurance, such treatment may have cost me hundreds if not thousands of dollars in the United States. However, in Taiwan, I was able to obtain prompt, high-quality care equivalent to that of a US hospital for a fraction of the cost.”
I conducted research and discovered that the overall cost of living in Taiwan is approximately half that of the United States. In the US, even a bee sting costs over $160 to treat. (An ER visit for a bee sting can cost $12,000 in the United States.)
Bozeat also noted that the taxes used to fund Taiwan’s health-care system are not very high.
Bozeat responded to the usual criticism that we’d have to raise taxes to pay for universal healthcare with the following listicle:
“5: Yes, taxes cover the cost of healthcare in this area. No, they are not high. Try it for yourself:The calculation for the NHI monthly premium payment for a single working adult is [your monthly income] x 0.0469 (4.69%) x 0.3 (30%) = your monthly out-of-pocket healthcare premium.”
I calculated a $60,000 annual income, which is $70.53 each month. [Sigh.]
But Bozeat wasn’t finished:
“6: It is not ideal. Not everything is completely covered. I had a positive experience, but I am sure many others have had [non-financial] medical horror stories here.
7: This system exists because the Taiwanese government believes that healthcare should be a right for all citizens, not only those who can pay for it. These are not my words; they come from the Ministry of Health’s English-language pamphlet. Every Taiwanese citizen and foreign permanent resident is eligible for and must participate in the National Health Insurance Program (NHI). Everyone is covered, regardless of job situation; no one is uninsured, and no one ever goes bankrupt because of medical expenses.”
This approach does not appear to impact the quality of care.
“I have yet to meet a Taiwanese person who wasn’t satisfied with, or even outright proud of, their healthcare system,” Bozeat said in an email. “My expat friends praise it, even those from countries with universal healthcare systems of their own.”
So there you have it. This definitely offers us enough to think about.