I'm not sure how comparable Taiwan and the US are, and a lot of articles try comparing the US to other countries when it is so vastly different. One of Taiwan's biggest schools is National Taiwan...
I'm not sure how comparable Taiwan and the US are, and a lot of articles try comparing the US to other countries when it is so vastly different.
Then you get to the costs of development of drugs. Drugs can take 10 years to get approved, and they can be denied at any step along the way, ruining a massive investment. Now, innovation and new drugs are important. Look at antibiotic resistance forming quickly. We need to be developing new drugs to stop these issues and to combat side effects and cross-effects with other drugs. From there, even if it is approved, there is no way to know whether or not it will be successful. Take the Lyme vaccine we had from the late 90s to the early 00s which was removed from market because anti-vaxxers claimed the drug gave long-term side effects, a claim which while never disproved, was never proven either. It was a vaccine which had great potential, but was squandered due to reasons completely out of the company's control.
Thirdly, look at the vastness of the US. You have tiny states like Vermont, New Hampshire, Delaware all with their own healthcare companies operating under different rules. Then you get massive states like Wyoming, with just over half the population size of the smallest state, Rhode Island. You can fit 63 Rhode Islands into Wyoming. The health needs of the states are vastly different, as are populations, and that's not to mention the issues of the rural hospital. Taiwan is half the size of Wyoming, and has 40x the population. They are not running into the issue of keeping rural hospitals afloat at a scale close to what America is.
Without getting into the issues of Insurance, comparing Taiwan to America is insane, they're separate worlds. Trying to gain any insight from one country's system and forcing onto another, one must look at the country as a whole, and Vox failed to do that. I would love a better healthcare system in the US. Try doing what France and Germany do though, regulate the systems that are in place, cap premiums, cap administrative spending, don't let claims be denied for bullshit reasons, let the government play the game. Also get rid of all the state-based regulations and bring it nationally, a wholly open, national system with a large amount of private players and the federal government. See who wins. But we need to tackle a lot of other problems before we just overnight switch to single payer like Taiwan did. Different worlds, the systems and implementations are not comparable.
If you're looking for a fabulous book on healthcare systems, look at The Healing of America, I was a big fan.
Yes, despite the headline I don't think it's straightforward to apply any lessons directly. External validity is always an issue when extrapolating from complicated systems, so this isn't the...
Yes, despite the headline I don't think it's straightforward to apply any lessons directly. External validity is always an issue when extrapolating from complicated systems, so this isn't the mike-drop argument that I'm sure some will pretend it is.
But it's still interesting to read an overview of recent history in other countries. All of it was new to me and I found the article valuable for that. This is supposed to be the first in a series and I look forward to reading about other countries.
Taiwan made its choice in the 1990s and embraced single-payer. It has required sacrifice: by doctors who believe they’re forced to see too many patients every day; by patients with complex and costly conditions who can’t always access the latest treatments; by citizens who have been asked from time to time, and will be asked again, to pay more for their health care than they did before.
The vast majority of Taiwan’s citizens today approve of their health care system. They know it isn’t a utopia. The country has made hard choices to keep this program sustainable, and it will need to do so again. That is what it takes to realize the single-payer dream.
I'm not sure how comparable Taiwan and the US are, and a lot of articles try comparing the US to other countries when it is so vastly different.
One of Taiwan's biggest schools is National Taiwan University and looking at their website, medical school costs about $2100/semester. Compare that to an UNC where it's $70,000 for an in-state student, and almost $100,000 for an out of state student annually. In America, the beginning debt of a doctor is so insanely high, high pay is necessary to offset that. The base of the problem is that.
Then you get to the costs of development of drugs. Drugs can take 10 years to get approved, and they can be denied at any step along the way, ruining a massive investment. Now, innovation and new drugs are important. Look at antibiotic resistance forming quickly. We need to be developing new drugs to stop these issues and to combat side effects and cross-effects with other drugs. From there, even if it is approved, there is no way to know whether or not it will be successful. Take the Lyme vaccine we had from the late 90s to the early 00s which was removed from market because anti-vaxxers claimed the drug gave long-term side effects, a claim which while never disproved, was never proven either. It was a vaccine which had great potential, but was squandered due to reasons completely out of the company's control.
Thirdly, look at the vastness of the US. You have tiny states like Vermont, New Hampshire, Delaware all with their own healthcare companies operating under different rules. Then you get massive states like Wyoming, with just over half the population size of the smallest state, Rhode Island. You can fit 63 Rhode Islands into Wyoming. The health needs of the states are vastly different, as are populations, and that's not to mention the issues of the rural hospital. Taiwan is half the size of Wyoming, and has 40x the population. They are not running into the issue of keeping rural hospitals afloat at a scale close to what America is.
Without getting into the issues of Insurance, comparing Taiwan to America is insane, they're separate worlds. Trying to gain any insight from one country's system and forcing onto another, one must look at the country as a whole, and Vox failed to do that. I would love a better healthcare system in the US. Try doing what France and Germany do though, regulate the systems that are in place, cap premiums, cap administrative spending, don't let claims be denied for bullshit reasons, let the government play the game. Also get rid of all the state-based regulations and bring it nationally, a wholly open, national system with a large amount of private players and the federal government. See who wins. But we need to tackle a lot of other problems before we just overnight switch to single payer like Taiwan did. Different worlds, the systems and implementations are not comparable.
If you're looking for a fabulous book on healthcare systems, look at The Healing of America, I was a big fan.
Yes, despite the headline I don't think it's straightforward to apply any lessons directly. External validity is always an issue when extrapolating from complicated systems, so this isn't the mike-drop argument that I'm sure some will pretend it is.
But it's still interesting to read an overview of recent history in other countries. All of it was new to me and I found the article valuable for that. This is supposed to be the first in a series and I look forward to reading about other countries.
From the article: