Thursday, November 21, 2013

(a)Musings: Korean vs. American Healthcare

Now, this post actually started out as a Facebook comment that expanded to ridiculous proportions, so don't think I'm presenting and structuring a well thought-out and convincing argument complete with multiple citations here. These (a)Musings posts, that's what they are - just rants.

I saw a post about universal single-payer healthcare systems existing in a long list of countries, some of which I wanted to know more about, including that of the country I'm in currently. Certainly the quality of the coverage in Korea doesn't compare to that of many other developed nations, but it's still superior to that of the U.S. At the end of the day, Koreans spend an average of 7.2% GDP on healthcare and related costs, while Americans spend 17.9%. That's coming up on 1/5 of all yo money, bitches. WTF? 

The national insurance of Canada and various European countries covers up to 90% of all necessary medical costs, but in Korea, it's only about 55%. I've mostly paid out of pocket for things here, especially dental work, because fillings, inlays and crowns (the most common things, I would think) aren't covered on the national plan, and STILL, STILL it is SO much better than the U.S. system.

One example is that of my coworker's wife, who's just given birth. She spent about a month at specialty maternity hospital receiving round-the-clock care (apparently giving birth is a 2-month process for Koreans) in plush accommodations for less than $600 per week. It's reputed to be the best maternity hospital in the country.

Let that sink in for a minute and ask yourself how much it would cost to stay in the hospital for an extra week in America because of complications following the birth of your child.

If you have a severe mental illness in Korea you either have a rich family and will live as a perpetual child or you will end up in the subway or on the roadside begging when your parents die. That's it. There's no system to take care of these people because no one wants the stigma of something like a learning disability, ADHD, autism or mild retardation associated with their family. These things are broadly undiagnosed and kids with them are usually just tossed into the general population. Depression and anxiety? Let's not even go there. In many public schools no one is allowed to talk about suicides, under threat of expulsion. Didn't happen. The famous "fan death" superstition is just a euphemism for things like "overdosed on pills", much like people (around 3/4 of all women in Seoul) have never gotten plastic surgery, they just "turned 20 and got prettier", "went on a really effective new diet", etc. 

The U.S. is obsessed with overdiagnosing and overmedicating all of the above because there's so much money to be made doing it. My point in all this is that Korea is in many ways socially regressive and fucked in the head (since hardly anyone's being treated for that), and they STILL have a universal single-payer system worked out that's better than ours. 

Seriously. 

Couple this with our failings in the areas of education and infrastructure and soon people will no longer be able to say things like, "Yeah, well, our quality of life is still way better than most people in the world, though". No. It's not. Compared to other developed nations, our population is ignorant and uneducated, healthcare and many aspects of living in general are astronomically expensive to the point of being laughably unaffordable, and our barely-acceptable aging infrastructure has been crumbling for years because no one's willing to allocate enough funding to fucking fix it. If you don't own a car where I'm from, you're barely a person. Because how do you get to work? Even if you give yourself an extra two hours to get there (when it would take maybe 25 minutes by car, let's say) there's no guarantee you'll get there on time. If the woefully unreliable bus does come sometime within an hour of when it's supposed to, it is slow, filthy, and quite dangerous.

Additionally, I'd just like to tack on how incredibly quickly Koreans do things. With one exception where I waited in an extremely busy English-speaking specialty clinic on a Saturday morning for nearly 2 hours after my appointment time to see a doctor, you're in an out before you even know what happened. I've waited like that in the U.S. just to see my GP more than once, to the point where I just had to leave again without being seen and without a prescription because I had to go back to work or school. Even in Korean hospitals you can mostly walk in, get a consultation, and walk back out in less than an hour. And it'll cost you, like, $8. 
For the most part bedside manner is sorely lacking, especially with male Korean physicians, but you can't argue with 40-minute out-patient procedures that would have taken like 3 hours in the States and cost 10 times as much. 
Prescriptions are the other great thing about this system - they're super cheap. Sure they come packaged in little individual plastic baggies or other suspicious containers, but shit, you can afford them easily. You don't have to worry about how much any basic prescription costs. You don't have to choose between medicine and groceries. Unless you want tomatoes or strawberries or something. 

Point is, everyone should have done it this way from the beginning and then improved upon the system as time went on. Leaving room for competition and mega-high earning potential is healthy and fosters the development of new techniques and technologies and all that great stuff, but who cares if only 17 people in the whole damn country can afford to use them? International recognition is only worth something if what you've developed is applicable or has the potential to be so.