Imagine Simply Going to the Doctor Without Running the Numbers First

A new report from Vox on Taiwan’s single-payer healthcare system helps fill out some details in this so-called “fantasy.”
Katie Way
Brooklyn, US
Woman paying bills
Photo by Jamie Grill via Getty Images

So you tweaked your back moving, or you’ve got a real throaty cough that you can’t seem to shake, or your ankle clicks when it’s raining because you sprained it really badly a few years back, or your lymph nodes swell up whenever you have too much white wine, or (most likely) you’re dealing with a heady cocktail of some or all of the above. Now you’re faced with a Choose-Your-Own-Adventure: Go to the doctor and spend an unpredictable amount of money, or suck it up and hope things get better on their own. It’s a brilliant lose-lose situation that encourages people to stay home instead of seeking treatment or open the black box of “medical care” that could send them down a path that ends with debilitating debt.


As we grit our teeth and power through our various health issues, the thought of a better way of living feels remote and too good to be true. But per a report from Vox, there’s already a place where that fantasy is effectively a reality: Taiwan. According to Vox, the nation-state’s healthcare system is the closest analog around to the Medicare for All policy currently being discussed in the Democratic Party presidential primary. And, per the report, Taiwan’s citizens are freaking loving it.

The healthcare system, first implemented in 2002 and funded by “payroll-based premiums,” “progressive income taxes” and levies on tobacco and lottery tickets, currently has an approval rating of over 80 percent from Taiwanese citizens. Per the report, the government-run system’s benefits include “hospital care, primary care, prescription drugs, traditional Chinese medicine. Patients must make copays when they visit the doctor or fill a prescription or go to the ER, but they are generally low, 360 NTD (about $12) or less.”

The effects are evident: fewer Taiwanese people die every year from preventable drug use disorders, lung cancer, road injuries, neonatal disorders, chronic obstructive pulmonary disease, ischemic heart disease, or self-harm than their American counterparts.

There are also prominent financial disparities when it comes to administrative costs, which only take up 1% of Taiwan’s healthcare funding, while an estimate released last week pegged American’s administrative healthcare spending at around 34% of its total costs. (“Administrative inefficiency” in the American healthcare system is responsible for $265 billion in wasted healthcare spending, according to one study.)

The concept of a healthcare system that just… lets you go to the doctor when you’re feeling sick? Without hideous financial repercussions? Like, you literally feel sick, go to the doctor’s office, and then leave with a plan and a reasonable bill for the medical services you just procured? Even if it feels too fantastical, the kind of thing we dismiss when we hear it promised to us by politicians (or, really, one singular politician), it’s worth remembering that it’s a reality elsewhere.

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