Dwight Lin has crunched the numbers on American health care and they don’t add up.
The Taiwanese man had moved his family to the United States in search of a good education for his children. “I thought the U.S. had similar [health] insurance structure to Taiwan.”
At the end of the 20th century, Taiwan was a rich country, but its health care system was shot through with inequalities (sound familiar?), with half the people not covered by any health plan at all.
So Taiwan set about to fix the problem by studying other countries’ health care systems. It came up with a plan that covers everyone, provides a wide variety of health services, and doesn’t require long waits for doctor’s appointments. All for 6.23 percent of the Taiwanese GDP, with administrative costs at 2 percent, the lowest in the world.
Should I warn Mr. Lin that here in the U.S. we spend a whopping 16 percent of our GDP on health care? That one out of every six dollars goes to doctors, hospitals, insurance companies or drug companies? Should I tell him that our private insurance companies spend 30 percent of our premiums on administrative costs?
He already knows.
“I shopped around and bought our family insurance plan,” he recounts, “and paid $500 a month and thought it covered everything, because it’s pretty expensive. In Taiwan, the insurance premium paid for an individual … is around $700 a year.”
Seven hundred dollars a year? And for this the Taiwanese get a full menu of benefits. “It has drug benefits, vision care, traditional Chinese medicine, kidney dialysis, inpatient care, outpatient care, just about everything under the sun,” says Hongjen Chang, one of the officials who formulated Taiwan’s healthcare system.
Here in the U.S., the $500 monthly premium is just the beginning of the story. Should I tell Mr. Lin that his policy will have high deductibles and co-pays?
He’s figured that out already as well. “I found in total every year I have to pay $17,000 to the hospital and insurance company if I use maximum service. Compare $17,000 with $700, that’s 24 times difference.”
But he’s not going to get 24 times better health care, which he has discovered as well. “One day my daughter got sick. We sent her to hospital, and imagined this society has good hospitals and advanced technologies that exist to serve people. We waited from 7 p.m. to 11 p.m. in emergency room. With this speed of service, I began to question my understanding of the word ’emergency.’ ” He says that he looked it up, just to verify that “emergency” is the word for something that requires immediate action.
“I don’t understand why they sent 5 to 6 nurses,” he says, “asking similar questions. And the bill? $3,200. Then I understood I have to pay that all by myself. A bottle of IV costs me $120, which is $3 in Taiwan. That’s 40 times difference.”
How do I explain this to Mr. Lin? Do I tell him that we’ve sacrificed our health and our peace of mind to the bottom line of corporate profits? How can I explain why we are so stubbornly turned inward that we won’t look to other countries to see how they solve problems and use the best of their ideas to craft our own solutions?
“But my story is not so different from other locals of similar needs,” he writes. “One of our teachers said he has to choose between the pain of illness or the pain of paying ridiculous insurance fees to get nothing.”
Unlike most of us, Mr. Lin has experienced something different, a world in which the country’s leaders worked hard to find a health care system that was fair and comprehensive, rather than one that drives for profit at the expense of the health of the entire nation.
“The U.S. should be able to provide an environment so that [being] poor doesn’t have to mean [being] sick, and becoming sick doesn’t make you poor.”
It’s hard to argue with that. Yet it won’t happen until Americans themselves demand a system that is focused towards good health care rather than high profits.
Ellen Schroeder Mackey (emackey61@yahoo.com) of Littleton is a librarian. She was a member of the 2007 Colorado Voices panel.
