The tale of 4 healthcare systems

Today, we visited the National Health Institute of Taiwan. It prompted me to think about the healthcare systems across 4 places I’ve lived in.

Four jokes:

1. A Taiwanese joke – a group of retired seniors have nothing better to do. They gather every day to meet in the most comfortable air-conditioned hall in Taiwan – a public hospital.
“what happened to Wang Qing today?” a senior asked his friends. “he is sick and had to stay home.” another answered.

Yup, this is Taiwan. Many young working professionals complain about the one of the most wonderfully expensive national health care system they have. While the national health institute published a satisfaction rate of 85%, I have not heard any compliment on the system by a Taiwanese. Stories of people abusing the systems are told frequently as jokes by the locals. Another interesting fact is their system covers all drug costs as long as doctors prescribe those drugs to patients. That’s why people here only want the most expensive drugs! Mandate of the system is to “make the wealthy help the poor, make the healthy compensate the sick”.

Conclusion: socialism at its best.

2. A Canadian joke – A senior goes to a hospital to get treatment.-> He did not make it to the doctor before he died.

This is Canada. Canadians complain about the long line in hospitals/ clinics in the country. Some even fly to the U.S. to get their symptoms treated. No matter you are rich or poor, you are supposed to line up to receive treatments. This is a pain for the affluent Canadians, whose opportunity costs for waiting are higher than others. Some advocate the Canadian government to allow large private hospitals to come into Canada, but was impolitely rejected. Another thing about the Canadian system is it does not cover costs of drugs. You could end up paying $225 for a prescribed medicine if you don’t have extra insurance coverage. Fortunately, generic substitutes are available for most medicines.

Conclusion: socialism’s lover, capitalists just need to keep flying to the south.

3. An American joke – “I have been thinking about the healthcare problem and how to pay for healthcare. If you took all the money the Republicans have spent trying to stop healthcare and all the money Democrats have spent trying to get healthcare, we could afford healthcare.” –Jay Leno

I don’t understand the American healthcare thoroughly. Because to me, much of it makes little sense. American politicians are better debaters than practitioners, which further complicates the issue. Even more scary is most citizens cannot really name what’s wrong with the current medical system in the U.S, either because it is too good or because it has way too many issues to name. A friend of mine who works in a clinic with low service fee had told me how many illegal immigrants went to that clinic to seek treatments because they offer subsidized 3 dollars per visit. A friend of mine who moved from Australia didn’t get medical insurance in the U.S. because it was ridiculous expensive. She would rather fly 30 hours back to Australia if anything major happens. A senior living in my community was complaining about her decreased Medicaid benefits.

Conclusion: socialists hate it, capitalists dislike it.

4. A mainland China joke – this is a long one.
A Chinese doctor walked into a cellphone store to fix his phone.
Service agent told him, ” 50 yuan to turn on the machine.”
“just like the hospital, we charge upfront before you get to see the doctor.”
The doctor reluctantly hands the clerk 50 yuan.
“so what’s wrong with the machine?” clerk asked.
“what, you asked me?!” the doctor grumbled.
“well, in the hospitals, doctors generally asked us that,” clerk replied confidently.
Doctor felt helpless, ” I don’t know.”
“great, 50 yuan to test the iTunes synchronization, 80 yuan to test the speaker, 70 yuan to test the screen circuit and 100 yuan to test the battery.” the clerk took out the calculator.
Doctor was furious, but considering the cellphone has the pictures of his mistresses, he had to get it fixed.
The clerk collects the cash, played with the phone for 30 seconds. Smiled to the doctor and said,” I don’t know what’s wrong with this machine. Please go to another store.”
The doctor wants to faint.

Excess fees, stories of patients dying, drugs killing you instead of healing you. I don’t need to name more issues to describe the healthcare system in China. However, a few of my friends who are practicing medical school students in China are all very kind and diligent. They sometimes suffer because patients’ general negatives views towards doctors. If you are a rich man living in China, you do not need to worry about medical care. Even better if you have a friend who’s a doctor. But for the poor, access to and affordability of basic medical care are major issues. Don’t be a poor in China. In fact, don’t be a poor anywhere.

Conclusion: heaven for the rich, who are not necessarily capitalists; hell for the poor, who think they are communists.


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