A successful health system
As a physician, I would like to offer a different perspective on physician-patient dynamics and the healthcare system in Taiwan.
Despite harsh criticism from all sides, we have probably one of the most accessible and comprehensive healthcare systems in the world. Although Canada and many European countries also provide their citizens with comprehensive healthcare, the cost of this "socialized medicine" is reflected by heavy taxation.
Although our physicians do not spend 30 minutes on each patient like their US counterparts, almost all Taiwanese citizens, rich or poor, have equal access to the resource. In contrast, one out of six Americans has no health insurance.
Taiwan nevertheless faces the question of how to entice the most talented people into medicine. Many medical students shun surgical fields because of the enormous workload, coupled with the meager financial rewards available under the current system. As a result, there is a growing shortage of qualified surgeons.
Moreover, the healthcare system is being frivolously abused by many people. Be-cause it's cheap and accessible, many patients continue"doctor shopping," logging 20 to 30 visits to a physician every year, severely taxing the system. This problem is complicated by people's desire to see only the "celebrity physician."
Furthermore, there is a lack of consensus on what the "standard of care" is. Many of the National Health Insurance Bureau's regulations and stipulations are not enforced, because of a severe lack of funding.
The standard of living in Taiwan has increased dramatically over the past 20 years, as have the cost of gasoline, food, clothing, etc. However, the cost of patients of healthcare has remained steady or even declined. On average, for example, it costs less to have an appendectomy now than it did in 1985.
We have demanded more and more from the system, requesting quality healthcare on a par with that available in the US and Europe, and often vent our anger through an ever increasing number of malpractice suits. Yet, we refuse to acknowledge the rising cost to the government of healthcare and medicine. Meanwhile, the National Health Insurance Bureau and many hospitals are working at full capacity, huffing and puffing. How do we solve this problem? I don't know what the solution is, but I believe everybody has to be a part of that solution.
In addition, we have to give our medical community credit for their efforts. Our research efforts are well-represented in major medical journals. Finally, I would like to share a vision of "success" from Ralph Waldo Emerson: "Success is to know one life has breathed easier because you have lived."
Kenny Liu, M.D.
Hualien
Lingle doesn't get it
Christopher Lingle should first get a clear idea of what globalization is before he starts to criticize it's opponents ("Glo-balization's critics miss the point of markets," June 10, page 10).
Percy Barnevik, president of the ABB Industrial Group said, "I would define globalization as the freedom for my group of companies to invest where it wants when it wants, to produce what it wants, to buy and sell where it wants, and support the fewest restrictions possible from labor laws and social conventions."
Globalization, moreover, is nothing new. The transatlantic slave trade, for example, provided labor for the plantations of the Americas. A combination of things including economic factors and movements against slavery led to it's abolition.
"Self-serving actions taken by individuals in a competitive market setting provide benefits that spill over to the entire community." Lingle seems to be distorting Adam Smith. Smith's "Invisible Hand" refer-red to small family firms operating under conditions of easy market entry and low geographic mobility, very unlike transnational corporations.
Transnationals can and do make decisions that cause great suffering to many others. Union Carbide's lax safety standards led to the Bhopal disaster that killed several thousand people. The United Fruit Co helped to plan and finance the 1954 Guatemala coup that restored military rule, and led to the deaths of tens of thousands of people in the 1960 to 1996 civil war. Nike benefits from labor repression in Indonesia. The WTO and NAFTA have both been used to overturn progressive environmental laws.
Anti-globalization opponents are very diverse, but most share the common ideal that corporate power and profit cannot be placed above all other social considerations.
Mark Munsterhjelm
Sanchung, Taipei County
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