Don’t try to deflect criticism of Taiwan’s NHI. The US health care system is not being discussed here. It’s incredibly obvious to all but a few that it is a complete disaster.
Care offered by NHI isn’t the best quality in the world, but it’s affordable and accessible to all (theoretically). Different clinics and hospitals may have different SOP on a medical problem so that’s why you need to switch to another when the one you try doesn’t show any promise. If you don’t like Hospital A because you think they are crappy, drive to another hospital. Usually research hospitals are less profit driven, at least on the individual doctor level. I really appreciate NHI for the above mentioned reasons. I am Taiwanese and we’ve come a long way from no insurance at all to what it is now. It even covers foreign students and workers. Please don’t trash it just because you have one poor experience. It’s one of our prides.
Can someone double confirm it ? I think this is interesting to know. I had the same question recently.
Spring festival this year, my 15 month son had fever over 40. A day later we went to the local doctor who specialize in kids and he gave 3 days of AB. I was suprised as in France it is minimum 10 days but didn’t complain. Then things got better and after 4 days, he got infection again (of course). Then we went to Adventist Hospital in ER. Service was great: very fast, doctor spent 15 minutes with us, confort us a bit and was speaking superb english. The guys gave us 10 days AB prescription and said the doctor before should have given 10 days of AB and advice us not to return there !!!
I don’t know for Spain but in France, it is not much in the culture to go to the hospital first specially in ER. In Taiwan it seems the local doctor is really when you have nothing (not even fever) and when you have something a bit serious => ER to a big hospital. For next time I learn the lesson and we will certainly go to ER immediately. I am sorry for your daughter and understand exactly: could have been us few months ago.
As per OP comment about the additional checks and stuff you have to pay: take another private insurance for your daughter. It costs few thousands a year and give you more cover. As per all insurance I don’t know exactly what it covers in extra but seems “good” according to my wife.
Quality is one thing (hospital, doctor, clinics…) and like everywhere, Taiwan has very good doctors and hospitals and bad one as well. Coverage of the social security is another thing. NHI is indeed better than nothing and every social security has its weaknesses. On the other hand, I find that what is covered is extremely limited and difficult to understand. When my wife delivered, we came across situation where we were told something like “this is covered, this is not, this one you can choose that medicine which is covered but not good while this one is better but no covered”. When you are in stressful situation this is not something you should deal with and it sound like a supermarket.
Especially when you are not fluent in the local language? There are optional meds you have to pay for yourself if you choose it, however it’s not something you must have. My sister delivered in a hospital, and we have to pay for epidural. It’s optional and frankly, there’s information available for something like this, on internet at the hospital. It cost us 7000+ nt, including epidural and everything. It’s good value, no? Without epidural, she could still deliver, just painful.
Every country has a different system and people manage it accordingly. You or anyone can’t expect ours in Taiwan matches yours in France. When you come to Taiwan, do it Taiwan way. When I go to France, I won’t complaint yours. Fair?
[quote=“mei0319”]Especially when you are not fluent in the local language? There are optional meds you have to pay for yourself if you choose it, however it’s not something you must have. My sister delivered in a hospital, and we have to pay for epidural. It’s optional and frankly, there’s information available for something like this, on internet at the hospital. It cost us 7000+ nt, including epidural and everything. It’s good value, no? Without epidural, she could still deliver, just painful.
Every country has a different system and people manage it accordingly. You or anyone can’t expect ours in Taiwan matches yours in France. When you come to Taiwan, do it Taiwan way. When I go to France, I won’t complaint yours. Fair?[/quote]
Why is it not fair to criticize the shortcomings of a system while praising the good? The fact is that there are shortcomings here. And people should be aware of them so they know that perhaps they should purchase additional private insurance or optional meds that the doctor doesn’t even offer.
Pure horseshit. Unless health professionals and the interested public can compare, contrast, and use best practices from around the world, then there is no progress. Your “love it or leave it” mentality for Taiwan’s system is pro-localization taken to the extreme! 
Hey you can’t insult A-Bian! He’s a son of Taiwan. 
Hey you can’t insult our medical system. It’s also a son of Taiwan.
Back to health. I’ve lived in a number of countries and rank Singapore the best. Multi-tiered but open access to all in terms of basic coverage. Private coverage is out of this world good in terms of service. I had private sponge baths during a week long hospital stay in the early 2000s and never wanted to leave. Very, very good infrastructure. Is it any wonder that Asia’s political class often send their leaders to Singapore when they are sick?
France? No air conditioning law in hospitals is weird. 
US system is still the best in the world (for drug research/inventions as well) although an older family member with heart problems recently received very good attention in Canada after the Hawaii doctors botched things (Hawaii medical system is no where near as good as Mainland USA). Not a huge fan of Canada’s system for non-life threatening stuff (long wait lists) but if it’s cancer, heart stuff, and other life threatening situations, Canada’s system is quick, costs nothing, and is very professional.
My family has also had good experiences in Australia, Malaysia, the UK, and Turkey.
Taiwan? Good equipment and no waiting times, but they provided me with a bogus diagnosis that left me very unimpressed. I have also been told horror stories from the 1980s (patient with hepatitis being isolated in a ward because they thought he had AIDS.). Was told that "if shit ever hits the fan in Taiwan, head to Singapore or Bumrungrad in Bangkok. To me, that seems like sage advice.
Theoretically, the world is a wonderful place.
Except for the zombies.
[quote=“mei0319”]Especially when you are not fluent in the local language? There are optional meds you have to pay for yourself if you choose it, however it’s not something you must have. My sister delivered in a hospital, and we have to pay for epidural. It’s optional and frankly, there’s information available for something like this, on internet at the hospital. It cost us 7000+ nt, including epidural and everything. It’s good value, no? Without epidural, she could still deliver, just painful.
Every country has a different system and people manage it accordingly. You or anyone can’t expect ours in Taiwan matches yours in France. When you come to Taiwan, do it Taiwan way. When I go to France, I won’t complaint yours. Fair?[/quote]
As one of our rare Taiwanese contributors who is not usually so defensive, I’m surprised to see you get so defensive here.
Now if you said don’t complain just because you are not used to the differences to your home country, I’d agree.
But if you are saying don’t complain about x/y/z because ‘this is the way it is here’, that’s no argument at all.
One of the major problems of the NHI is the massive waste and over prescription of drugs . Often you even tell the doctor I don’t need this syrup or that pill and they STILL prescribe the dn things, because they make money off them. That’s hurting the taxpayer, it’s causing premiums to increases, it’s bad for the patients liver, it’s unprofessional, and its greedy.
I have the same problem for myself right now. I had a small infection in my throat, and got prescribed 3 days of medicine on wednesday, complete with antibiotics in one of the small clinics close to my house. Even though I said “no” when asked if I cough, the doctor still prescribed cough medicine. Now it’s monday, and I’m in worse condition. The visible infection was gone on day one, but the pain keeps increasing and now I fear that the infection might’ve spread to my windpipe and I can’t see it. Now to think of it, back at home (Turkey) we get prescribed with antibiotics for at least 7 days, and don’t take them 3-4 times a day, but every 8-12 hours instead. Will visit NTU hospital today and see what the doctor says.
[quote]US system is still the best in the world [/quote] :roflmao: It’s certainly number one for reference pricing and spend per cap. It’s maybe number one for R&D. It’s not number one for medical outcomes.
I wrote about this some time ago…This is my view of the Taiwan medical system after working closely with it for about 5 years.
[quote]So what it wrong with the Taiwan hospital system? Overall the standards of care have stagnated or declined over the past 10 years.
- Infection control was never a strength in Taiwan and despite SARS things have gone backwards due to budget pressures. When combined with the large highly resistant population we have here due to years of over prescription, it might be an potentially explosive combination (note weasel words). But if SARS happened again, are we better or worse prepared? I think worse due to declining standards caused by cost cutting.
- Most of the efforts to reward hospitals for improving quality (as far as I’ve been told) have fallen by the wayside.
- Very high dissatisfaction levels among Doctors and Nurses especially about working conditions. It used to be you gave a red envelope for service, now there is nothing to get. Under the old capitation system, you worked long hours, but that made the hospital money. Now each patient is a drain on your budget and without a gatekeeper, you have no control over how those resources are allocated - the patient decides how you spend your budget
Doctors that prescribe too many meds get fired (a good and bad thing). Not only that but Dr discretion has been greatly curtailed (a good and bad thing). - Taiwan has implemented the most bureaucratic and non-standardized regulatory system outside of Japan with correspondingly long approval times - think one or two years to get approval. Increasingly it is used as a tool to keep thing out of the budget. This combined with low prices this means that many companies couldn’t be arsed to bring their products to Taiwan.
- In my experience waits are increasing and Dr have less time to spend per patient.
- There is a lack of decision making over whether NHI is an insurance scheme where premiums should go up or a social benefit. Thus each year we are locked in major budget issues. Opening up supplemental health insurance was a great move.
- Overall funding is derived from payroll taxes which is stagnant - it’s even hard for them to support the 4.5% annual global budget increases. [/quote]
Let me add to this Taiwan has one of the worst ratios of outpatient vs. impatient in the world Additionally, all hospitals are only getting about 0.9 TWD for every reimbursable dollar they spend.
Taiwan is not the best example as a model for healthcare delivery as the most popular feature, and the biggest reason for its budget issues, is lack of a gate keeper. I can shop doc’s all I want and no one will make me stop (BTW the IC card is supposed to slow this down, but record connectivity is less than desired). If I don’t like the answer in the morning, I can up and get a second opinion in the afternoon. This ends up being a vicious cycle. Due to a lack of a gatekeeper, doctors are overloaded and have no time to make a proper diagnoses, which combined with a lot of medical ignorance, leads to more complications down the road and more use of the system and more doctor shopping with no limits which leads to long wait times and 5min diagnoses.
We haven’t touched the corruption is the system, though I believe, (just a guess), has lessened somewhat from 10 years ago.
Takin 3-4 times a day is easier on your liver and gives a more continuos dose,
The doc should insist on you coming back in 3 days later for check up and follow up prescription. This is a big weakness.
Although its not surprising for a cold/flu to last many days (my cold/flu only started getting better after 5 days with distinct periods of pain/runny nose/coughing etc.)
In your case you can go to a hospital if worried and check with the ENT specialist I guess. You can even register online first if somebody can help with the Chinese or you just go there and get a ticket.
Sorry, did not read all pages. Remember when we had the fertility testing thingy with wife Adventist hospital also charged extra. Saying, we can test THIS way and it will really hurt or THAT way and it hurts less. Despite all that they did not find the solution for the very simple problem as well, we had to go to a private doc for that (tablets for 3 days and there was Junior 
Hope she gets better soon!
No medical system could cover all procedures under a universal health system, simply impossible.
It definitely is number 1 for R&D. No other country is even close for number 2.
[quote=“bob_honest”]Sorry, did not read all pages. Remember when we had the fertility testing thingy with wife Adventist hospital also charged extra. Saying, we can test THIS way and it will really hurt or THAT way and it hurts less. Despite all that they did not find the solution for the very simple problem as well, we had to go to a private doc for that (tablets for 3 days and there was Junior
Hope she gets better soon![/quote]
This doesn’t seem to be related to public private but rather doctor shopping and clinic shopping, something that most couples would (wisely) do for fertility problems. Worked for you luckily! Many many people need a lot more help. Taiwans IVF system is very well developed , it would not be fair to criticize it I think,
[quote=“mei0319”]
Every country has a different system and people manage it accordingly. You or anyone can’t expect ours in Taiwan matches yours in France. When you come to Taiwan, do it Taiwan way. When I go to France, I won’t complaint yours. Fair?[/quote]
Fair what ? Read again my posts: I never compared nor said French system was better, I don’t think it is just possible to compare two social systems as a whole. Beside, I don’t “come to Taiwan”, I live here, I am a tax payer here and I contribute to the NHI system like everyone else. This give me all the rights to point out what is good and what is not good in this system.
You didn’t compare? Please read your own post. Good to hear that you are paying tax. So, we are square that you do your French way in France, and there’s no need in trashing NHI, like saying our hospitals are like supermarkets.
Critics is good, whining is counter-productive. If you do think there’s much room to improve, do something about it. Make your opinion heard, and push for a change.
[quote=“ChewDawg”]
US system is still the best in the world (for drug research/inventions as well) although an older family member with heart problems recently received very good attention in Canada after the Hawaii doctors botched things (Hawaii medical system is no where near as good as Mainland USA).[/quote]
ChewDawg, I’m not trying to be argumentative here, but why do you think that the US has the best healthcare system in the world? Every single ranking I have ever seen ranks it pretty poorly…the last WHO ranking, for example, ranked it at #37 in the world.
I’m American and I think that the quality of care in the US can be excellent, but overall I would certainly never call it the best system in the world. Far from it actually.
No I didn’t. Quote the sentence in my post please that I can see where you see a comparison between NHI and French national care…
I don’t get your point about you do the French way in France and the Taiwan way in Taiwan. Obviously I do the Taiwan way here, I am living here and I am not trashing it.
In the situation I was in, I did feel we were in a supermarket, yes and this is not bashing, it is a pure fact. I don’t know if you had kids here but do the whole process in Adventist Hospital (I don’t know for others) and you’ll see: they handle you a paper where you have to choose what care you want, which item is optional, which item is included, what is the extra costs… I never said it is good or bad, it is just like this here. When it is a planed thing like baby delivery like my situation, it is indeed clear what you pay and not pay and you don’t even have to decide on the spot, when it is an emergency, you end-up like the OP having, in a stressful situation, to decide what you take and don’t take.
This you are right. I’ll do it 
They usually answer all the letters.