There are not many things a 20-year-old Taiwanese immigrant could claim to have expertise in, right? You might have expected a “but” to come after that sentence, but I’m saddened to inform you…there is none.
Hi. It’s me. I’m the 20-year-old Taiwanese immigrant. My name’s Quinn Sental, born Pu Chih-Yu, and I’ve been in the US for a little under two years now. In that time, I’ve observed a few differences between the US and Taiwan—especially between the healthcare systems.
Before you read on: It might surprise you to learn that not everything about the US healthcare system is worse! Don’t get me wrong, though, most of it is upsetting to me. And I’m hoping that some of you will read this article and tell me it’s actually not as bad as it seems.
(Or you may read this piece and think I have no idea what “bad” means. Feel free to send your inside knowledge to [email protected].)
That’s not how hospitals work?
On the first day of my internship, my editor sat me down and asked me, “What’s a hospital?”
My editor is very smart (Editor’s note: Flattery rarely works, but it’s always charming.), so I made the educated guess that she didn’t actually forget what a hospital was. “A place where there are doctors who you can go to see?” I answered.
“Not usually,” she said.
“Oh.”
It turns out you can’t just walk into a hospital in the US and expect to receive care. What usually happens is you have to contact your primary care physician and hope they’ll schedule you in soon and hope they won’t refer you to an out-of-network specialist.
Phrases Quinn has learned in the US:
- Primary care physician
- Specialist referrals
- Out of network
- Not expecting to receive care
Hospitals work a little differently in Taiwan. You can enter a hospital, make an appointment for that same day, and receive all kinds of care in the same building. Doctors are easily accessible, and there is no such thing as a referral-only appointment. Also, the cost for medication tops out at $10.
Ten dollars. Yay for national healthcare! Which brings me to my next point.
Private insurance is the norm?
I speak three languages: English (natively), Chinese (also natively), and Spanish (passably).
And somehow, despite knowing three different grammar systems, hearing an explanation from my editor, and having watched this video explaining US insurance, I still can’t wrap my head around the idea of a deductible.
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I can understand paying a monthly fee for coverage. I can understand paying a small amount of money for every hospital visit. And even if it makes me want to hold a boom box outside every single US resident’s home blasting James Arthur’s “You Deserve Better,” I can understand—or at least tolerate—the idea of premiums and copays.
But having to pay a certain amount of money for healthcare on top of those fees and out of your own pocket seems absurd. And it’s made even worse by the fact that you can choose to have a high or low deductible.
It’s so ridiculous, it sounds like the start to a middle school math problem. Quinn is a new college graduate making minimum wage in New York City. If they don’t plan on getting hit by a bus and have no chronic health conditions—but would really like to not go bankrupt if they have to go to the hospital—how many hours should they spend crying in the shower tonight?
Speaking of crying in the shower…
I’ll be honest: There is one thing the US does well that Taiwan can’t hold a candle to, and that is mental health care.
Mental health care is a taboo subject in East Asia. There’s a general sentiment that depression and anxiety don’t exist; you’re just “tired” or “hungry” or “need to drink more water” (which can be true and still not be why we are sad and anxious).
I’m not saying it’s a perfect system here. But the fact that now I’m able to seek out mental health care that I’ve felt I’ve needed for years—from therapy to medication—is something that I’m certainly not taking for granted.
That’s enough nice things to say about the United States
Before starting this article, I had a list of bullet points I wanted to write about, but I had to mind my word count.
Again, if you have anything at all good to tell me about the US healthcare system, I implore you to do so. If I touched on a topic of your expertise, feel free to email me and tell me all about it! I’m here to listen, learn, and hopefully come away a more educated person because of it—even if it makes me upset. Because if it does, at least I’ll be able to talk to my therapist about it.