***Kudos to you if you got the reference in the title of this blog entry. ;)
If the US medical system were ever pitted against the South Korean one in a MMA rumble, I think Korea would win. And then whoever lost, would hope that they went to a hospital in Korea. ;)
Before we begin, let me set down some rules for this "brawl". These will help foster a fair fight: (1) bring in only facts from expert sources (2) try to listen to each other without personally attacking (3) try to look at things from all viewpoints and judge what might actually be best.
However, I'm going to just share my first-hand experiences here so that it is a bit more "personal". I come with twelve years experience of living in South Korea and from having a father who is a doctor in the US, so possibly my viewpoints are a bit informed.
For you, Americans:
Can you please try to suspend your previous conceptions and just look at other approaches to healthcare? I will be blunt and say that I think a lot of Americans get so stuck in just looking at things within the American borders that they cannot consider how maybe another country is providing healthcare. More so, I think that so many Americans get stuck in their own party affiliation or ideologies that they cannot discuss other viewpoints with respect and love (that is for both Republicans and Democrats). I hope that this blog will pry open a healthy and respectful discussion or at least someone thinking outside their echo chamber.
As I wrote earlier, I have lived in South Korea off and on for 12 years. During that time, I have visited the hospital many times more than I did during the 31 years I lived in the US. Well…my dad is a doctor, so we should first exclude the times that I hung out at his clinic. 😉 In the US, I hesitated in going to the doctor because I could never really afford it, so I just endured ailments that I had unless it was a dire situation or called my dad to get his opinion of what I should do. Here, I go to the doctor for any little thing, and I think that is wiser since many major diseases are best handled if you get them early.
To illustrate how hospitals are viewed differently here than in the US, I’ll tell you a quick story. When I first came to Korea, my students sometimes came to class late and gave the excuse that they had to go to the hospital. Coming from a culture where hospitals are the last resort, I would freak out. “What?! Are you dying?” It took me a while to figure out that hospitals and clinics are just so accessible here that going to one is not seen as a big deal. For crying out loud! Some elderly people go there just to break up the monotony of their days! Now let’s get into some specifics I have observed.
Cost of Insurance: These are what it has cost me to be insured (when I could afford it).
United States – major medical insurance with a $5,000 deductible for one person: $100 a month (in 2010)
South Korea – all-inclusive with no deductible for three people: 144,000 KRW or $120 a month. The cost is about the same for everyone, but it depends on how much you make.
Now, let me explain a bit more about how it is in South Korea. First of all, my wife and newborn son are on the national healthcare because everyone is covered no matter what (usually). If you work full-time, your workplace must help pay for your national health insurance, and you pay half as well (I think it is half, but I’m not for sure how all that works since it is automatically taken out of my paycheck). My university provides additional private health insurance for my entire family, and I could even get more private health insurance to just cover lost wages and other expenses (for maybe another $200). As well, my pension has disability insurance. So, in short, I pay a bit more than what I did in the US eight years ago, and it covers A LOT more for just a bit more…for more people.
All of this is possible because the Korean government acts as my insurance company (single-payer healthcare). The hospitals and clinics remain independent of the government, but they get paid by a “big brother” who really goes to bat for us citizens. So, we don’t have to worry about insurance companies that are over-charging their “clients”, and, at least from what I can tell, the red tape to get something paid for is reduced enormously. I go to the hospital or clinic and show them my government-issued ID, and that’s it. No receipts. No calling the insurance company to beg them to pay for this or that. It is head-ache free. The insurance doesn’t pay for all of it, but more on that in the next section.
Cost Per Visit: In the US, unless I went to a clinic provided by the government or an organization, I usually could expect to pay at least $60 just to see the doctor (that was what I generally paid back in 2010). Here in Korea, a visit to a clinic will usually just cost me $5. If I go to the top hospital in the nation, it will cost me a whopping $10. If I see a specialist at the top hospital in the nation, it might cost me $15. Unheard of in the States, right?
How is this possible? The Korean government helps set a cap on how much a hospital or clinic can charge for each procedure and such. They can charge less, but there is a cap. And the national healthcare insurance pays for most of the costs…but not all. So, there isn’t a lot of frivolous procedures requested by patients because you still have to pay something (usually…and, honestly, there can be frivolous procedures ordered on the hospital or clinic side, but I’ll try to mention that later).
Let me just give a recent example. I have had these two bumps on my legs for years. When I first discovered them, I rushed to the hospital in Seoul and got them looked at. They told me not to worry, and that I didn’t need to get them excised. So, for years, I tried to ignore them. Though, a few weeks ago, I decide to just get them cut out…just in case. So, I visited a local clinic. The doctor there was this constantly smiling guy who seemed to really love his job! He told me that I didn’t need to get them cut out as he was sure they weren’t malignant. Can you believe it? He actually, at first, wasn’t going to do the procedure because it was unnecessary! “But doc, can you do it just for my peace of mind?” Sure, no problem. Long story short, the tumors weren’t malignant. Total, it cost me $70 (80,000 KRW). That is for a completely unnecessary surgery, tests to make sure what the heck it was, six follow-up visits to make sure it was healing well and to take out the stitches, and meds (including antibiotics when the one on my right leg did get a bit infected). The doc’s beside manners were excellent, and I got in to see him usually within 10 minutes (once it was 30 minutes on a Saturday). If I ever need tumors removed, I’ll go to his little clinic which is a 15 minute walk from my place.
In the US, I would have never even dared to get it checked out! I would have probably waited until it was eating up my legs before I visited the doctor. And that is just one story out of many!
Quality of Care: But you might be thinking, “well, that’s all nice and dandy, Christensen, but I’ll stick with my doctors here in the US because they are the best with the best technology and the best meds!” Are you sure? Possibly, I couldn’t afford the best in the US, so I can’t compare the best in the US versus the best in South Korea. Though, I will tell you this. I prefer going to a doctor here in South Korea than in the US! By far! When I was a poor teacher in Chicago, I had to visit the government-run clinic there, and I saw a doctor there for only five minutes who I’m not sure actually listened to me. I think he half-listened to me and ordered some tests that cost me more than I had budgeted. Mind you, this was after a two-hour wait in a long that extended out the door even before the clinic had opened! And I just remember walking away hating the whole experience, but it was all I could afford back then. When I could afford to go see a doctor at a private clinic in the US, I got more personal care.
But honestly, I get the same as a private clinic in the US for less here…most of the time. Granted, there are some doctors and departments here that try to fit in as many patients as possible so that they can make “enough” money since they are getting paid less. But that doesn’t matter to me. Since it costs less, I can get second, third…fourth opinions. And it still costs less than in the US! And in less time! In short, I prefer the quality here in South Korea. It can be a hit or miss sometimes, but it is loads better when you consider what is accessible to the average citizen.
Wait Time: “But you have to wait months to get a procedure done, right?” Nope. Never have waited for anything, really. Okay. A few times I did. When I saw a specialist once, I did have to make an appointment a month in advance, but that might also have been because I didn’t have the time to see them earlier because of my work schedule.
I don’t know how it is in Canada or the UK, but I really don’t see the “long waits” for a procedure that are rumored to be in those countries. And the wait for a procedure seems to be longer in the US than in Korea!
As well, in Korea, I get impatient if I have to wait more than 10 minutes in a doctor’s office or hospital. Seriously. I do. I remember recently showing up at a dermatologist with only 30 minutes to spare before having to meet a friend for lunch. I thought I could get it all done in 30 minutes. Sadly, I was wrong. But it really does show what is pretty usual here. Like I mentioned above, in the US, I would often carve out a whole morning, taking time off from work, to go see the doctor. Even with an appointment, I knew I would have to wait at least 30 minutes. Has that changed, Americans?
Here, I often don’t show up with an appointment. 😉 Before you think, “well, that’s because there are less people there!” Nope. Seoul has a higher population density than most cities in the US (look it up! I think maybe NYC might give Seoul a run for their money, but I’m pretty sure that Seoul has one of the highest population densities in the world). There are just so many more clinics and hospitals here that the wait times are reduced (and just more efficient, I think).
Lack of Choice: I often hear from Americans that if the US adopted a single-payer system or similar that they will need to give up their choice of which doctors they go to. Ummm… I found that more true in the US! I couldn’t afford the really popular docs in the US! I had to stick to the cheaper ones or the “free” clinics. My choices were greatly limited in the US because of that. Here in South Korea, my choices are bountiful! For instance, I have a ear wax problem. I produce too much, and my ear canals are more narrow than normal. So, I have to clean out my ears at least every other month. In the US, I had to do it myself, which is risky, but I couldn’t afford just going to a doc to have them do that. Here in South Korea, I always go get a professional to clean my ears out. The usual cost is $5. And I visit various ear, nose and throat doctors (이비인후과) to see which one is the best for me. I found one near my workplace, but I have decided to stop going to her because she chided me on coming to her without ears dirty enough (ummm…shouldn’t I be the one to judge that?). She usually was a bit churlish, but I endured that since she was good at cleaning my ears out without hurting the sensitive ear canals. I might stick to the one near my place even though his clinic is a bit “old” (as in the wall paper is a bit old). He is great equipment with a video to show me how the inside of my ears look, but that is standard. See! I can be picky here in South Korea because there is LOTS of choices!
Preventative Care: One of the things that I enjoy the most about the healthcare here in South Korea is that, since it is so inexpensive, I go to the doc for really any reason. I don’t go for a simple headache, but I could! I do go if an ailment is bothering me for a week or so.
As well, the healthcare here provides a lot of free tests. Every two years, I get a complete physical done…for free! They do the usual blood work, endoscopy, and so forth. A funny thing is that they charge extra for anesthesia when doing the endoscopy or colonoscopy. My wife is a trooper, and she opts out of getting knocked out. I did that once. Never again! Knock me out, please! It only costs an extra $70, so I’m willing to pay for it. And the government sends me letters saying I can choose to get all these tests done for free at a low cost…because I’m getting older.
Cancer runs in my family, and one thing I know about cancer is that it is more manageable the earlier you get it. I’m thankful that I can get tests done to find these things early before they really become a problem.
I never once had a physical in the US. Not once in 31 years (except ones done by my dad). I never even considered doing an endoscopy or colonoscopy when I was in the US.
Even if we move back to the US, I think it will be cheaper to fly back to Korea and get those physicals done here. I hear that it can cost a whopping $400 without the insurance.
So, anyone interested in medical tourism? 😊
Problems with the Korean Health Care: In the years I have lived in South Korea, I have only met one foreigner who didn’t like the medical system here. Personally, I think it is because she just had one bad experience. I’m not saying that every clinic or hospital or nurse or doctor has wowed me. Definitely not! Though, overall, I have been impressed with the medical system here.
There are only two major problems that I see. The first is that, since there is a cap on how much a hospital or doctor can make per patient visit, some doctors and departments try to cram as many patients in. At the top hospital here, I went to one department[1]…let’s just say the department wasn’t one with a lot of emergencies. 😉 After a longer than usual wait, I got to see the doc, a specialist in his field, and that was just for five minutes in which he just repeated what the other doctor had diagnosed without really looking into the history of my ailment or asking me questions. When I complained to the international department (one I had frequented a lot), they apologized by saying that it was like that in that department because they had to meet a quota. Though, this is a rare experience in South Korea. For the most part, I have had a longer amount of time with a doc than I did in the US.
The other problem is that, like teachers can be, doctors don’t really like someone looking over their shoulders. I think this is true in the US and South Korea. So, I have come across doctors who wanted to do these crazy procedures. For instance, I was having some back pain, so I went to a local hospital. The doc then showed me an x-ray and explained that my back was not curved as it should be. He then said I needed out-patient physical therapy with shots going straight into my back each time I came in. I went to another hospital to get a second opinion (a hospital that I trust), and they said that diagnosis was totally bogus. My wife was told by a dentist that if she didn’t get a certain procedure that she would have this horrible over-bite. Five years later, her teeth are fine. But these are the exceptions, and it is still so inexpensive that I can get second, third and fourth opinions to just check a diagnosis.
I could go on and on comparing how South Korea has a better healthcare system than the US, but I doubt I have convince those who are already against “socialized medicine”. I could point out that we already depend on the government in so many ways (roads, police, military, fire fighters, water…and so forth). What is one more thing that will benefit the community? Do you think possibly Obamacare was engineered to fail by those who were against it from the start (such as insurance companies)? Okay, okay. You hate everything Obama did. Granted, he did some things I disliked too. But can you for a second put all of that aside and just look at how other countries are handling this issue? Maybe, just maybe, the US can find something that will work.
In the meantime, if we ever move back to the US, I’ll just fly back to Korea when I need medical attention. It will still be cheaper than seeing a doctor there! But sadly, I will have to give up preventative care…and just visiting a doctor to clean my ears.
[1] I have intentionally kept it vague what hospitals and such I am talking about because libel laws here are insane, and I could get sued if it is deemed that I spoke “badly” about a business or person.
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