jerryfromchicago 寫:
Appreciate the article from keatsmoore. It raised an interesting question regarding the health care system in Taiwan: is it a social welfare system or health insurance system? Well, if you go by the Chinese wording, it should be health insurance but the practice of it appears to be not as clearly defined so now we have a mishmash situation wherein no one can live without it but no one like it either. Frankly when I first heard about the idea of a national health care system and later when legislation was passed my immediate reaction was that in the end this thing will just creat a financial blackhole and bankrupt the whole country. Of course fortunately this worst scenario has not occurred but things have gone bad enough that some drastic changes has to be in place to save the system. My pessimism then arose from the fact that the most wealthy country on earth, namely, the US, would not even dare think about a national health system, how then with the limited resources in Taiwan, people thought of it as doable? I want to believe that whoever proposed it meant good for the whole country but forgot that not everyone is as unselfish or law abiding as a doable system requires. Let us face it: regardless of the system in place, it all come down to one word: "money!" Obviously the pie is only so big and it does not matter how we slice it, there bound to be people who get the bigger slices and some only get the crumb. However since life and health is such a human right and emotional issue, no one will conceed that his or hers is less important then others' and does not deserve equal treatment. Regretabbly the thing that I have observed after working in health care for almost thirty years is the "human deficiencies" that I mentioned in the previous posting. Of course this kind of greed and abuse is everywhere but particularly more rampant in health care system because of the emotion and human right issues tend to prevent responsible parties from scrutinizing the practice the way it should be. Let me give an extreme example: a therapy assistant working in a rural nursing home in Illinois would daily round up the residents, did group exercise sessions then charged the government for individual treatment reimbursement. She was rumored to make a quarter of a million dollars a year when her equals made only one tenth of it. The nursing home turned a blind eye because it benefited too. Of course this most likely would not have happened had a private insurance company been involved but then it is also true that "when there is a will, there is a way." Pardon me for this lengthy description but my point of view is that there is a need to balance between limited resources and undeniable right to affordable health care while not discounting the existence of abuse or overuse. I will readily confess that I am good at playing a devil's advocate but am at my wit's end for propsing any sensible solution. Maybe private insurance system is the practical way but how willing are the people in Taiwan for this changes? Honestly I will not hold my breath for it.
Speaking of human right, I must give up the whole ideas of health care, charity, and greed etc. Human right, oh… human right! How many evils things are done by the name of human right? The homeless people sleeping on the street without whole day meals. Should everybody in that country donates their money to resolve the homeless people problem? Do the homeless people have human right to live or to eat? Or even to thrive?
No, human right is optional.
Back to the origin of the basic concept, as a modern citizen who must be responsible for his health, not the whole state to take care of him, unless the state is quite rich.
There is no such states in the world up to now.
It is only an idealistic or even crazy idea to take care all the people’s health by the nation’s hand only.
I have seen many uneven events in Taiwan health system, including the discrepancy of the reimbursement of different diseases.
All human are equal. Yes, they seem so, but only in oral speaking of “human right”.
All human are not equal in their body status, and reactions after therapies. Why can they receive the same reimbursement in advanced planning?
Medicine is individualized in caring and treatment. All the resource should not be equally applied to the people who need treatment. The privilege persons own the special route to medical access. The people of no connections have to wait on the line for admission and further invasive tests.
People have the right to choose the way they should be treated, not by the order from the government.
As I read form the journals of American medicine years ago, it mentioned that patient needs water, it is “just” water, not the mineral water in patient’s mind.
If the people have the right to pay more or less for their health, they should have a choice. That is their “human right”.
Let the choice of the people decide the monopoly the government or the availability of the private insurance company to take care of their health.
In Taiwan now, people are obliged to pay money for the insurance fees, even they have their own private insurance.
The government takes it all by the power people give to the nation and steal the economic competition from the civilian’s cooperation and even smash the “human Right” of the people to choose their own health care system.
Let the people choose.
The government has no right to take it all, especially, they have shown their disability and incapability now.
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