I read this description of the Taiwanese health system with interest.
Kevin Bozeat, a 25-year-old student, wrote about coming down with severe gastrointestinal symptoms while studying in Taiwan: stomach cramps, bouts of vomiting that would not abate and, perhaps worst of all, the inability to keep any fluids down.
Around 3 a.m., he decided it was time to go to the hospital for treatment, not knowing what to expect having never been to a hospital in Taiwan — a country that has a national health-care system, or as Bozeat wrote, “socialized medicine.”
He was checked in and given IV fluids within 20 minutes of his arrival. Phlebotomists drew blood and the lab ran tests on it. Hospital techs performed an ultrasound to make sure he didn’t have gallstones or appendicitis. And eventually they diagnosed stomach flu, gave him two prescriptions and discharged him.
“Each day since I’ve gotten progressively better and am now pretty much back to normal,” Bozeat wrote. “The bill for the ER visit? . . . US $80.00.” [WaPo]
Sounds lovely. His conclusion?
“Taiwan is less wealthy than the US, yet it spends less and gets more out of its healthcare system. We see the same story repeat itself,” he wrote. “This debate is all so tiresome, because there is no debate. Universal healthcare works, it can be done here, it can be done in any country with sufficient resources. All we need is political will and an implementation plan.”
And this is where I can’t help but get a little bothered, because he’s missing one detail: who’s developing the therapies the Taiwanese are using? That’s where there may be a fly in the ointment. Long time readers are well aware that I’m not necessarily in favor of the private sector controlling the medical sector as it currently does, but one must consider all the factors in a world in which medical systems are not isolated from each other. The information and drugs that are the lifeblood of health systems flow from health system to health system, but it costs money to develop them. A lot of it.
So, when Bozeat think all it takes is political will, he’s neglecting to ask how much of Taiwan’s admirable efficiency is enabled by the basic and commercial R&D performed by other health systems. Do the Taiwanese develop their own therapies, or do they use therapies from other systems? And then ask the same question about the United States health system.
I’m not arguing for or against any particular system; I’m criticizing the analysis presented as being too simplistic. What happens if we shift to single payer and suddenly things get no better and we didn’t foresee that? To charge confidently ahead as he appears to be recommending seems a bit foolhardy to me. There are certainly efficiencies that can be attained, but what will be the drawbacks?
