Christian Adams Off Topic

Off Topic: The Dollars and Sense of Health Care

Day 5: Not a happy camper.

My extended visit to Taipei City Hospital Renai Branch in Taiwan, was the result of an “atypical infection of unknown origin,” and mercifully ended today (08/20/12), after six long days and five nights. Though the illness was never life-threatening, it continues to perplex the doctors, and this ordeal is far from over, albeit on an out-patient basis.

The U.S. health care debate has divided the country into roughly three segments. If you support the idea of nationalized health care, you’re branded a left-wing, anti-American socialist, standing hampton every time the “terrorists win.” If you oppose any idea of universal coverage, you’re called a right wing, uber-patriotic moron, riding shotgun with, well shit, your shotgun. The third segment of the population is floating aimlessly in the middle of this debate. Those of us who might think, “Hey, if Canada can pull it off, why can’t we?” but also remember that this is the U.S. government we’re talking about—the most corrupt organization in the First World—yeah, those fucking assholes, taking the reins of our collective well-being. I don’t know about you, but I don’t like the sound of that. Look what they’ve done to Amtrak.

No matter what your position in the matter, one thing we can all agree on this that health care in the U.S. is outrageously expensive. Like, stomach-turning. If God forbid something should happen and you do not have health insurance, you are fucked. F-U-C-K-E-D. If you should be lucky enough to have insurance, you’re not exactly off the hook, either. There are arm-and-leg premiums, deductibles, co-pay plans, and coverage limits. You will pay for it, one way or another.

$29,000 – And she’s not talking about Monopoly money, either.

Take for example our friend, Aneta Dubow, who has chronicled her very recent closed head injury on her weblog, radio tania. Check out a screen grab of a recent Facebook status report.

That’s right, $29,000 for two days in the hospital, not including the extras.

And then consider the flight of this little bumblebee. From the onset of my admission into the hospital, I was subjected to a myriad of tests including but not limited to several x-rays, an ultrasound, an MRI, a dozen different blood screenings, and a two-stage nuclear medicine whole body PET scan. For the first two days and nights I was in a two-person ward, before being transferred to the isolation ward, where I lived in comparative hospital luxury. Meanwhile, there was competent and extremely polite round-the-clock care from nurses and attendants. My only complaint, other than being stuck in a hospital for six days (without a clear diagnosis), is that the remote control for my flat screen TV didn’t always work unless you held it in a certain position, which made channel surfing somewhat of a chore.

Following this morning’s battery of tests, and inspired by Aneta’s post, I moseyed down to the cashier at window 13, to inquire about the running total of my bill.

“Why do you want to see [your bill]?” the cashier asked with a queer expression. “Have you been discharged?”

“May I see it, please?” I pressed.

“OK, OK,” she said.

Now I already knew how much the two-person room cost on a daily basis (800 Taiwan New Dollar = $26US) and wasn’t surprised to learn that the luxury suite on the 1oth floor goes for 2000TWD = $66US. However, I was shocked to see my running total: 24,000TWD = $800US. That number seemed a little low to me.

“This [includes] everything?” I asked in my pidgen Mandarin. “Really?”

The cashier looked blankly at my face. “Yes.” She then rattled off a four-sentence string of Mandarin, of which I maybe caught six or seven verbs, most notably fuqian [foo-chee-en  v. to pay money].

“How much of that [am I responsible for paying]?”

“Wait a minute,” the cashier said, clearly annoyed. “Give me your insurance card.”

I handed over the IC and let my gaze wander around the main lobby. The cashier took a phone call and I heard the rasp of a dot matrix printer in the background. After a minute or so, she said, “Here. You pay this.”

I looked at the figure on the dot matrix printout, shook my head, and said again, “Really?” Deep down inside I was holding back a hearty and incredulous laugh.

“That’s correct,” the cashier said. “Now get the fuck out of here and leave me alone since it hurts my brain to decipher your Chinese.” Haha, no, she didn’t really say that second part, but my ESP was tuned extra tight. She was thinking it, maybe.

OK, so never mind that six days of fairly decent hospital care could possibly cost $800, guess how much of that 800 is coming out of my pocket? Zero dollars. That’s because I have insurance, courtesy of the country of which I’m not a citizen, but legally work and reside. Anybody who works legally, has residency, pays taxes in Taiwan is entitled to universal health care. Or you can just be a citizen. This coverage is extended to alien residents, I guess, since we’re contributing to the pool just like everyone else. They seem to be really good about stuff like that around here.

Upon discharge, very few words were exchanged with the cashier at window 13. I handed over the discharge papers, my IC, and 4500TWD ($166US), which I was more than happy to do, since I knew I was going to get reimbursed for it somewhere along the way, and seriously, $166 for six fucking days in the hospital? Sold, done deal, I’m in.

Granted, I did not need paramedics or have surgery like Aneta did. The fact is I crawled in the front doors of Renai Hospital after a week of low grade fever. Of course I knew I had insurance and could just waltz down to the nearest hospital and this thing could have been addressed two weeks ago. But I’m stubborn and I’ve nursed myself through way worse. The point is I didn’t avoid the medical care because I was worried about paying for it.

Universal health insurance is obviously not free, for chrissakes. Everybody has to pony up some cash once a month. Now guess how much I pay in monthly premiums. No, not zero, but damn close. I pay 500TWD = $18 per month. My income tax rate is somewhere around 7% and who knows how much goes into the health care system, but it clearly can’t be all that much. I’m hesitant to even tell you about the ingeniously cheap dental coverage, since it might spark a violent wave of dental tourism and quite frankly, there are already too many fuckers with bad teeth running around Taipei. However, here’s a breakdown of the costs for say, a crown. One hundred and fifty TWD ($5), at the door. That’s it. I had a filling pop out not too long ago. Went to the dentist. While I was there he said, “Hey, I noticed a couple of caries in there. You want me to put ceramic fillings on ’em?” Sure. How much? Five dollars.

People, forget Canada. If Taiwan, population 23 million, can pull off universal health care, every free country in the world should be able to do it. By the way, Taiwan is a democracy, perhaps even more so than our beloved U.S. of A., and in a few select ways, like health care, they are showing everyone How This Shit Is Done. One thing is for certain, in countries where universal health care is the law, it won’t cost you and arm and a leg, even if you just so happen to injure your arm or your leg. And that’s something every U.S. taxpayer should think about, real hard, before pissing on Obamacare or referring to Paul Ryan as the Mengele of Medicaid.

By Christian Adams

Writer and musician in South East Asia

2 replies on “Off Topic: The Dollars and Sense of Health Care”

I think the silver lining of being one of the last fucking countries on the planet without some form of universal coverage is that we have a myriad of excellent models worldwide to pick and choose from. In typical American fashion we can only manage to look one country north to one of the lessor functioning models. On another note – glad you are feeling better and are back in action.

Laura, what do you think it’s going to take for the U.S. get it together (in terms of health care)? Is it even possible, given the corruption involved via pharma, insurance, and primary care providers, not to mention special interest lobbying groups?

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