Healthcare Showdown: Taiwan vs. the US
Did you know that seeing a doctor in Taiwan only costs around $3? One of the best aspects of Taiwanese society is its universal healthcare system, while the healthcare system of the US is unfortunately one of its worst aspects. Taiwan’s healthcare system is the National Health Insurance (NHI), which works through people paying monthly premiums depending on their income. This also helps pay for the elderly’s healthcare, as those above 70 get full subsidies.
In Taiwan, all you need to do to take advantage of the NHI is to pay your monthly dues and bring your 健保卡 with you. Many Taiwanese citizens who live abroad like to return to Taiwan to get tests done or treat major illnesses, as healthcare costs in the US are outrageously expensive. Even if you’re a foreigner and pay out-of-pocket to see a doctor, it’ll only set you back NT$400 (~$12) at a local clinic, and this includes any medications that you might need that the doctor prescribes.
健保卡/NHI card
In the US, most people rely on private health insurance, mostly covered through their employer. However, depending on the plan, the out-of-pocket costs and monthly premiums may be expensive. For example, with some high-deductible plans, it could cost thousands of dollars for some scans. There are also many types of plans, which can be confusing to navigate and difficult to select which one is best for each individual. Also, finding care is difficult. There are shortages of select professions (especially primary care physicians and psychiatrists), with patients having to wait months or seeing a physician’s assistant or nurse practitioner instead.
The US does offer public health insurance for low income individuals, the Medicaid program. However, to qualify for medicaid, the cut-off is very low. The max income for a single individual is $19,392 and for a family of 4 is $39,900, hardly a comfortable income in the US. Those who earn just enough to not qualify for Medicaid but who can’t afford private insurance are in a tough spot, and usually go without insurance. Those with Medicaid are also limited in the doctors that you can see, as you can only see those who accept Medicaid. Usually, the quality of physicians won’t be as good, since doctors aren’t as willing to accept Medicaid patients since they won’t be reimbursed as much compared to other insurances.
However, there are still some bad aspects of having national health insurance. The quality of care that you receive from physicians may not be as good as those you receive in the US. Since seeing a doctor is so cheap in Taiwan, people visit the doctor anytime they feel like it, causing long queues and worn out doctors. Doctors in public hospitals in Taiwan may see over 100 patients a day, and so patients get very little face-time with doctors. This can lead to incorrect diagnoses and also stress or overwork for doctors. Rich Taiwanese may opt for private hospitals, which aren’t covered by NHI, but they won’t have to wait hours in queue and can also have more time to speak with doctors.
Taiwan’s “Black Cross Movement” protest for healthcare reform 11/19/2023
I’ve also found that doctors more easily prescribe medication to patients in Taiwan vs. the US, and are less fearful of potential consequences. For example, some controlled substances such as Xanax and Adderall are extremely difficult to obtain in the US, while in Taiwan you can ask your local clinic’s doctor and easily receive a handful. Maybe this is due to doctors being more likely to be sued for malpractice in the US as compared to Taiwan. It’s also pretty standard to receive medication for most ailments. I was surprised when I had a common cold and received a long string of packets of pills. It was about 5 pills per packet, with 1 packet to be taken every meal! In the US, it’s rare to take medicine for colds, and people usually tough it out through taking over-the-counter medication or just dealing with it since seeing a doctor is so expensive.
Despite some of the negatives I still prefer Taiwan’s healthcare system. Healthcare should be a universal human right that should be accessible to everybody, no matter their income or status. However, Taiwan’s NHI system faces the problem of funding itself due to the declining birth rate. The declining birth rate means that there might not be enough money going into the system to pay for the elderly in the future. However, hopefully Taiwan’s economic division has a plan to protect the NHI from bankruptcy and allow the nation to continue it’s affordable healthcare.
