On Feb. 18, US college student Kevin Bozeat wrote a Facebook post titled “The horrors of socialized medicine: A first-hand experience” in which he described seeking medical treatment in Taiwan. Bozeat stressed that Taiwan provides high-quality care, but charges low fees.
Bozeat’s post has been shared more than 200,000 times on Facebook and was even reported by mainstream US news media, including the Washington Post.
Some of the reports say that the US would do well to learn from the National Health Insurance (NHI) scheme.
While many think Taiwan should be proud of the NHI, people should also consider who is sacrificed for such a glorious achievement and the effect that cheap medical fees might have on its international image.
In describing the treatment he received at National Taiwan University Hospital’s Department of Emergency Medicine, Bozeat wrote that he received the best treatment available in Taiwan for only US$80.
He was amazed by the short waiting time, and the medical and communication skills of the doctors and nurses. The same care in the US would probably cost many times more, he wrote.
Bozeat probably does not know the real reason Taiwan’s healthcare system can provide such affordable treatment: It places unreasonable limits on medical fees and personnel costs.
Excessive suppression of personnel costs leads to widespread problems of long work hours for doctors and nurses.
Although a new doctor can earn an annual salary of NT$1 million (US$32,361), higher than many other professions, it is still nowhere near as high as the starting salary for doctors in Western countries who meet comparable standards.
The healthcare system also makes no clear distinction between the fees charged to insured and uninsured people. Even for foreigners who are not enrolled in the NHI program, hospitals and clinics can at most increase their fees by a proportion relative to the standard NHI reimbursement, while standard NHI reimbursements are minimized to begin with.
Low salaries for doctors and nurses, and unreasonable price controls, create what many foreigners see as Taiwan’s “healthcare miracle.” This situation sacrifices the respect that doctors and nurses ought to enjoy, while using tax funds to subsidize prices. If this is a Taiwanese miracle, is it one to be proud of?
When US mainstream media reprinted Bozeat’s post and told readers about Taiwan’s cheap medical fees, many reacted with amazement. For the vast majority of Americans who do not know much about Taiwan, this kind of reporting could give them the impression that this is a relatively backward nation.
In capitalist nations such as the US, low prices generally indicate substandard quality. Social psychology experiments have even shown that if a product has a cheaper price tag, US consumers doubt its quality.
Americans could react in a similar way if they picture another nation’s quality of healthcare based on US costs, without having experienced it.
Although Taiwanese are proud of the quality of medical treatment here, the price could give Americans a completely different impression.
Taiwan has always wanted to get closer to Western nations. It could do so by wielding its soft power on the international stage.
If Taiwanese want to be friends with Western nations on a basis of mutual respect, they must work hard to alter the image that they are proud of low prices.
Although is it important for Taiwan to be visible on the world stage, Western countries should not be drawn into thinking of it as a land of cheap, rugged products.
What the nation gets from such an image is not respect, friendship or willingness to treat Taiwan as an equal — it is mere sympathy from those who see Taiwan as needing help because it is backward compared with the US.
Dennis Weng is an assistant professor of political science at Sam Houston State University in Huntsville, Texas.
Translated by Julian Clegg
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