Day 75: Taipei

A day in the life of Taiwanese health care

After feeling a cold coming on yesterday, today I woke up with a fever, which is rare for me so we were a little worried having just been in China.  By mid-afternoon my fever had gone over 100 and we went to go see a doctor.  It would be my first time experiencing health care in a foreign country firsthand.

Doctors visit
We walked to a famous local clinic, which is only about 10 minutes from where we were staying.  We checked in with no appointment and let them know that I didn't have any insurance in Taiwan.  They took my information and gave us a number, we were number 16 and they currently were on 14.  We sat down and after about 10 minutes our number was called.  We sat down and Charlotte explained everything to the doctor, he took my vitals and said my temperature was up to 102 and given my weight loss in China he advises that we go straight to the emergency room.  He tells us that there is no charge, because he didn't do anything!

Emergency Room
We took a cab to the ER of the most famous hospital in Taiwan, the National Taiwan University Hospital, and walked up and took a number to check in, this took about 5 minutes.  The nurse called us in and took my vitals and information on what was wrong.  It also took a while to figure out how to input my name and in what order, at fist they had my middle name and first name reversed.  It was amazing that they never even asked for identification, I had made Charlotte go back after we had left the apartment to get my passport, but it turns out that they never asked for identification.  We then were told to go to internal medicine and wait until the doctor called us in.  This took slightly longer and we had to wait about 20 minutes until the doctor called us in.  Unlike in the United States, the idea of privacy is not an issue in Taiwan and the doctor talks to you in a large room that has about 3 other doctors also talking to patients and they have other patients charts open on their desk.  Once we went through the problems again she said the best thing to do is to get a drug from the pharmacy to decrease my fever, then get a chest x-ray,  blood, urine and saliva tests done and to get me an IV to make sure I am not dehydrated.  We then went back to the waiting room to wait for a bed.  She said before anything gets done we would have to pay since I did not have insurance.  The total bill for the ER trip, IV, X-rays and lab work would be $130.

This wait was longer and took almost half an hour before the doctor came out and said that we should go get the X-ray first and then come back because we lost our place due to much sicker people needing it, but we were the next on line.  We went and got the X-ray done in about 5 minutes and came back.  We now had to wait another 15-20 minutes and finally a bed was ready.  Before getting the bed I had to provide a urine sample and also a saliva sample.  In the US they normally swab your cheek for this I believe, but in Taiwan they just ask you to spit in the a sterile container.  They then took some blood and hooked me to an IV and wheeled me to another room to wait for the lab results.

After about 45 minutes the doctor came in and said everything came back looking normal and it was probably nothing too serious.  We asked her if it could be H1N1 and she said they don't treat that any different now than any other flu, but she can do a quick test to see if it is in that category and if so we can get drugs to speed up the symptoms, but it was not necessary if we didnt want to.  We decided to do the test and she had to put a stick up my nose and it felt go halfway into my brain to get a mucus sample to test.  The test would take about 45 minutes.

Randomly while we waited, Charlotte's sister appeared at the foot of the bed with a hamburger for me and food for Charlotte.  When we asked her how she ever found where we were in the hospital, she said that she went to the front desk and told them she was looking for a tall foreigner.  Someone overheard her and directed her to internal medicine.  Once there she asked again if anyone saw a tall, white person and they directed her to my bed.

The tests finally came back as positive for flu, which could be H1N1, but does not rule out other seasonal flu.  She said that she could give us drugs to decrease the fever and help with the symptoms, this test plus the drugs increased the charge an additional $60 and we were free to go.

I was already feeling better after the IV and my fever had decreased dramatically.  Overall the ER visit in Taiwan with no insurance took 4 hours from check-in to check-out for $190 including prescription medicine, x-ray, iv and lab tests.  I was worried about if my insurance would cover it, only to figure out once I saw the bill it would be below my deductable anyway.

For patients with insurance it would have cost about $50 because the prescription was not necessary and would not have been covered.  Insurance in Taiwan is available here for all residents for $20 a month (less if income is below a certain level) and there is no deductable.  All hospital visits, including long-term care are basically free.

Anyway I spent the rest of the day in bed, so there isnt much else to discuss today