The Horror! The Horror! The Horror!


#1

One thing that get’s me about Taiwan and I think reflects a lot on its society is the state of medical practice.

To me this is underscored by how many times one has to go and see a doctor to fill a simple prescription for antibiotics. If you have some rudimentary infection, such as an ear infection, it could quite reasonably take up to 6 trips to the doctor just to fill the prescription.

Doctors tell you they are only allowed to script 3 days worth of antibiotics. Most first line antibiotics take 12 days to kill off even a staph infection. Given that in Taiwan it’s unlikely that the first line antibiotics will be effective anyway you will have to go back another two times to fill the second line prescription. This practice is illegal in most civilized countries.

Added to this churning the doctors receive per pill payments from the pharmacuetical companies. Hence Taiwan has the highest rate of pill presciption in the world. This is another practice which is illegal in most countries. Finally, the hospitals are allowed to dispence as drugstores which is another illegal practice in the civilized world.

The odd thing is that everybody is complicit in this practice, the hospitals, the doctors and the government. The people are hearded around like mindless morons putting up with it. It’s the typical bully you, stuff you around, sh#t on your kitchen floor if you leave me nothing to steal attitude that permeates all Taiwanese thinking. And I’m reminded of Kurtz every time I’m stuffed around by it when he reflected on the darkness of his own soul.


#2

Hexuan,

Don’t get me wrong. I have no difficulty with the public insurance program in Taiwan. My problem is with the way it is ripped off by the medical profession and their general attitude toward the public.

Here’s an example of attitude.

Last year my wife discovered she had ovarian cancer. The original doctor who discovered the condition said he had to operate immediately so she went to the Cathay Hospital the next day. The doctor removed the tumor told her it was malignant, but that he didn’t do the staging surgery because it takes a long time and he didn’t have enough time. “He didn’t have enough time!” They were the words of his supervizing onocologist. If you know anything about cancer therapy, staging surgery is the most fundamental thing to have done. You have no idea if you have a 10% chance of survival versus a 95% chance.

Needless to say we went elsewhere. Fortunately, for me I happen to know the general manager of American Home Products subsidary operation in Taiwan. He was very helpful in getting my wife in to see one of Taiwan’s best. I don’t want to seem disparaging here of my wife’s onacologist as he has been excellent. However, and this all goes back to attitude, on the day of her staging surgery after I had been waiting in the waiting room for 5 hours without a single word on how things are going the surgeon came out with a staple gun in his blood soacked hands and said, " Can you run up stairs to the 13th floor and buy one of these for me so that we can finish sewing her up?" Not a word of a lie. Where in the world would anybody have the audacity, the sheer lack of common sense, the stingy stuff you attitude to make such a request? What’s more, it’s not as if there are not a hundred other people sitting around eating biendan’s in the surgery area.


#3

Sorry Fox. I actually deleted / edited my post because I saw it was just a bit of a patronising rant. very confusing now you have replied to it ! Sorry !

I take your point. Medical treatment in the UK though is in a crisis, and there are mind boggling figures just released on incompetence (“adverse incidents” I think the report called them) and a culture of cover-up.

The difference in the UK is that I pay in extraordinary amount of tax, as does every worker. Where on earth does the money go ? Crap schools, crap hospitals, crap roads, crap trains, the list is endless. If I was only paying 10% income tax and NT$1000 a month for my Jian Bao here, I would think, well, you get what you pay for.


#4

I recognise that bs about having to go back to the doctor every week to renew the prescription, patently ridiculous!

I used to teach a TaiDa doctor English here and he illuminated me on certain aspects of the system here.

The thing is most of the professionals here realise it’s a very much ‘get them in the door-out the door’ system but it’s difficult for them to change that quickly. They are under enormous pressure to give pills if the patient comes to them (pull factor). I believe this comes from an ingrained Chinese medicine mentality. I call it going to the doctor to collect my smarties (as anyone who has ever worked at a kindergarten here will testify!). Taiwan also has the world’s highest use of antibiotics in animals so I wouldn’t be surprised if were all taking a steady dose everyday and we don’t need prescriptions.

The push factor is of course that GPs and hospitals run their own pharmacies meaning they make a profit on every one they sell and it’s so easy to bill the national insurance system. This doctor was the most amazing guy who worked in the ER here and he was very concerned about more recent issues such as quality of life care for the terminally ill and how to personalize medicine. He agreed with me the system is set up for quantity not quality. There are many quality doctors out there but if you want to be sure , as Hexuan says, you ALWAYS get what you pay for.

The national insurance scheme is buckling under the overprescription of drugs so expect this system to be much reduced in the near future from a cost perspective. The Taipei gov’t and the central gov’t are arguing over who will have to foot the bill.


#5

I recognise that bs about having to go back to the doctor every week to renew the prescription, patently ridiculous!

I used to teach a TaiDa doctor English here and he illuminated me on certain aspects of the system here.

The thing is most of the professionals here realise it’s a very much ‘get them in the door-out the door’ system but it’s difficult for them to change that quickly. They are under enormous pressure to give pills if the patient comes to them (pull factor). I believe this comes from an ingrained Chinese medicine mentality. I call it going to the doctor to collect my smarties (as anyone who has ever worked at a kindergarten here will testify!). Taiwan also has the world’s highest use of antibiotics in animals so I wouldn’t be surprised if were all taking a steady dose everyday and we don’t need prescriptions.

The push factor is of course that GPs and hospitals run their own pharmacies meaning they make a profit on every one they sell and it’s so easy to bill the national insurance system. This doctor was the most amazing guy who worked in the ER here and he was very concerned about more recent issues such as quality of life care for the terminally ill and how to personalize medicine. He agreed with me the system is set up for quantity not quality. There are many quality doctors out there but if you want to be sure , as Hexuan says, you ALWAYS get what you pay for.

The national insurance scheme is buckling under the overprescription of drugs so expect this system to be much reduced in the near future from a cost perspective. The Taipei gov’t and the central gov’t are arguing over who will have to foot the bill.


#6

One annoying aspect of this 3-day treatment thing is that they stamp the “Jin Bao” (insurance) card each time you go back. I had a troublesome infection last year and they stamped their way through 2 cards before they finished! It did not take long to see the doctor each time, but as the card number increases, the cost per visit to the doctor increases. It is really a big nonsense!

One argument that does work in my experience is to say you are going on a business trip abroad. They will bend the rules in this situation.

The other way is to get the 3-day prescription, go the pharmacist and buy the other 4-8 days worth across the counter. It might be cheaper, but it is definately cowboy medicine!