MUZHA DISTRICT, TAIPEI — For about a week or so now, I’ve been bugged by a very annoying earache. Waking up with a bit of build-up and generally, feeling like I’ve gone for a sleep-swim every night.
Fortunately, I’m one of the 99% of Taiwanese who are covered by National Health Insurance.
One of the many success stories in Taiwan is their respect for and investment in population-level health. It’s not a perfect system — many quality indicators could be improved, and some wonder if the system is “too nice” in terms of health expenditures — but it achieves its goals: a healthy population, with access on demand.
Indeed, many have credited Taiwan’s health system as one factor explaining how a nation with such strong (albeit tenuous) ties to China has handled COVID-19 so successfully — no known community infections, few deaths, and very little disruption to daily life.
Armed with my insurance card in hand and NT $150 in my pocket, I’m off to the clinic.
When you step inside the clinic, it’s a pretty simple process. First, it’s very clean and sterile as we’d expect … and that includes all patients. You’re directed to a wash station for a hand sanitizer and a paper mask, nothing that some of this is likely reaction to COVID-19. Many infections in Taiwan have come from hospitals and clinics, after all.
Following, I’m asked for my National Health Insurance card, and my Alien Resident Card to confirm that I am who I say I am. Most everything in Taiwan is database-driven, so I surrender both cards and wait patiently. The cards are linked to a one of the largest and most comprehensive national databases of health information in the world. Some have credited this database with providing data points necessary to push back on COVID-19. Others have expressed concern over privacy concerns, naturally.
All said? My ear hurts and I need to get it taken care of. About a minute or later, I’m with the doctor.
A quick conversation (in English), and he’s able to check my ears. Peeking inside both, he compares the left to the right and decides pretty quickly that there’s a mild infection and some blockage. He asks me if I’ve been using Q-Tips and sadly, I have to come clean: I’ve been breaking the Cardinal Rule of cotton swabs.
He’s able to diagnose the issue, but he doesn’t want to clear the blockage himself, as it can cause damage to the ear drum of not done properly. Fortunately? There’s a specialist clinic just down the road, and they’ve got the proper ear, nose, and throat specialist to make it happen.
I asked him when I’d need to schedule that. He responds by handing me a hand-drawn man, and explaining that the clinics are open right now. No delay, no scheduling.
He even hands me back my NT $150, because in his view “he didn’t really do anything.”
About 10 minutes later, and after confusing one clinic for another (as I said, there are clinics all over the place), I find the right place. As with the other clinic, the scenario is the same: sanitize and mask, and then a quick ID and insurance card check.
The NT $150 that I was refunded earlier? That’s the same fee for the specialist. Within five minutes, I’m back in the examination room. The specialist greets me, confirms the infection, cleans it out, and dispenses a medication.
I left the house at about 09:30, and I’m back in my apartment by about 10:30. In that 60 minutes, I’ve seen a general practitioner and then a specialist. I’ve had my ear treated, and I’ve been given a proper mediation. In both offices, I’m treated with dignity and respect, and an honest concern for my well-being. I’m even given the opportunity to purchase some face masks — a NT $15 for three masks — out of concern for others’ well-being.
One hour and $5 US later, and I’m back to continue my day.
In debates about how to best keep a population healthy, I’ve got quite a bit to think about.