Test driving the dirty "socialist" health care system

I've had this small lump in my armpit for about 10 years and never had it looked at, at least not by someone with any medical credentials. I do notice that it changes size based on deoderant use, in some way shape or form. After doing some internet research years ago, I try and stay away from aluminum based deoderants. There was a product called "Crystal" that seemed to keep the lump at bay, but it did little for sweat relief.

When I first arrived in Taiwan, I thought the lump had gotten smaller, for whatever reason. Then last week it got bigger, and bigger, and then started to hurt. I hadn't really given much thought about medical care in Taiwan. I do have a National Health Insurance ID card. And I know my company has a 3rd party group insurance plan. I don't have that ID card yet, maybe I should check on that...

But I never thought about where I need to go when I have a very painful golf ball sized lump in my armpit. So I harnessed the power of Shirley's helpful HR group and came up with Dr. Kao in Tien Mu near Mitsukoshi. No appointment necessary, he's in the office Mon-Wed-Fri. I cleared my schedule in the afternoon and headed up there. It's a hundred meters or so up Lane 69 and is clearly marked on the outside; I thought for sure I'd have to walk down an alley and through a butcher shop and then give the secret knock before heading up a spiral staircase... But not the case. Maybe I'm getting too jaded about certain Taiwanese things.

The receptionist was very friends and spoke English well. She handed me a form to fill out and asked if I had a National Health Insurance card. The form was quite simple, where do you live and are you allergic to anything. I sat down and called Shirley to let her know that I was going to see the doctor and before she could even pick up the phone, Dr, Kao opened his door and called me in.

He also spoke English well and must have lived in the States for some time. You can typically  tell by the idioms that people use whether they ever lived in the U.S. I explained the situation and his eyes lit up like a kid in a candy store when I got to the part, "I have this lump in my armpit" and he was chomping at the bit to have a look. As I was slipping my arm out of my shirt he quipped, "At least we know it's not breast cancer!"

Check. No breast cancer.

Upon seeing it his diagnosis was instantaneous and I was relieved that he wasn't going to try and squeeze or poke it. He said it was an abscess caused by a bacterial infection and a cyst in my armpit. The heavy sweating in the middle of the Taiwan summer caused things to get worse as the sweat glands are blocked and next thing you know, I'm smuggling a Titleist under my arm. The plan is to treat the bacterial infection with antibiotics and leave the cyst be. We did talk about the potential of surgery to get the cyst out if the problem comes back which I honestly, wouldn't mind doing, to be rid of it once and for all.

They were able to prescribe me an oral and topical antibiotic right in the office, no trip to a pharmacy necessary. He said it would take about 3 days to see an effect. I can't wait for day 3 because on day 2, this thing is quite painful. At least it's growth appears to have been stunted. The cost of the office visit was $6 USD and the 2 prescriptions was $2, total. The cost of the NHI plan to me is about $16/month, I suspect my employer contributes a chunk, too. I spent a total 20 minutes in the office, as a walk-in.

I can only speculate that the biggest problem in the United States is the legal system. Some things in Taiwan are cheaper than in the U.S. but it is not off by an order of magnitude. I can't imagine this health care system working in the United States. Part of the magic of the Taiwan system is supposed to be the efficiencey of processing. My NHI card has a chip in it with all the necessary data and there is little to no paperwork on the part of the doctor office. They just scan the card and computers do the rest. But with all of the efficiencey in the world, think of the burden in the U.S. from the civil legal system. Can national health care become a reality without tort reform?

My visit to Dr. Kao did not unlock all of the philosophical mysteries of a national health care system nor equip me to render expert opinion on the entire scope of Taiwan's health care system, but I can at least say one thing with confidence:

"It's not a tumor!"