Bring on the national health care!

Monday, December 1, 2008

One of the things that South Korea does well is national health care -- at least in my experience. Matthew pays 2.2% of his paycheck, his employer matches that, and all three of us have coverage.

Here is my standard OB/GYN visit:
I walk in (no appointment necessary) and hand my little pregnancy booklet to a nurse at the front counter. She gives me a little strip on which to urinate (testing for excess protein in my urine). After I get back from the restroom, I check my own blood pressure on the automatic machine, then weigh myself. The nurse records both.
I take a seat. After about 10 minutes (20 on a busy day), the ultrasound technician calls me in to her room. She checks out the baby's vitals and measurements. About half the time she prints out a picture for me.
I return to the waiting area. After another 5-10 minutes, I'm called into the doctor's office. We discuss any test results, symptoms, etc.
Finally, I return to the front counter to pay. My usual bill is W20,000, which used to be about $20 before the exchange rate went to hell. Currently, it's closer to $14. My most expensive visits, with various blood and urine tests, have been W60,000.

That's impressive, but the truly impressive part is yet to come.

Liam is sick. He has a bad cough and now a slight ear infection. There's a pediatrician's office in the same building as my OB/GYN. We've now taken him in three times, as the doctor wants to check his recovery frequently.

Here's Liam's visit:
Parent gives child's insurance booklet to counter nurse. Another nurse is simultaneously checking his temperature via an instant ear thermometer while he plays on the slide or rocking horse in the waiting area. Within 5 minutes, parent and child are ushered into the doctor's office. While Liam screams and (at least when accompanied by me) pulls parent's hair, the doctor and nurse work together to listen to his lungs and heart, check his throat and ears. The doctor then gives directions to the parent (or the other parent if both are there and Liam is still screaming in first parent's ear). The bill and prescription are all on the same paper. Today we were in and out in about 10 minutes total.

Total cost per visit: W1,800 to 2,800 per visit. Yup, that's about $2.00.

We take the prescription to the pharmacy across the street from our apartment building. (There is an on-site pharmacy, but we like our local pharmacist and prefer to give her our business.) She gives us the medicine in small bottles (just the right amount for the two or three days until the next doctor's visit) labeled with the amounts and times per day to be administered. She also throws in free vitamin C tablets.

Total cost for 2-3 days worth of medicine: about W3,000. That's the same price I paid for a little toy train at the discount shop down the street after Liam's second doctor visit.

I will point out that something like 92% of medical facilities in South Korea are privately owned. It's a very different system than many countries with universal health care. But it certainly seems to work, at least from my vantage point.

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Yeah -- between national tax, pension, and national health care, it's a total payroll deduction of less than 5%.

Gotta love Korea for that!

My daughter and boyfriend are going to Korea this August to teach English, I am wondering how one signs up for the national health care program. Is it done automatically through payroll deduction or some other means? A little bit of guidance would be helpful.

Thanks, Tom, Salt Lake City

Their employer should take care of everything. It's a standard payroll deduction, along with national pension (which is reimbursable for US citizens when they leave the country). They should get little insurance booklets within the first month or two. If they're working for public schools, there's nothing to worry about. If they're working for a hagwon (private academy) that can be one of the first clues to whether everything's on the up-and-up. I say that because I've have friends whose employer did not pay pension or insurance. They never got insurance cards, but didn't realize they should expect that.

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