Taiwan’s health care system is humming along and obsessed with cutting costs, creating frustration among doctors who sometimes have to work 80 hours a week. Their offices are often open until 10 p.m.
In Taiwan, doctors process patients at the pace of a grocery store cashier. When the emergency director of National Taiwan University Hospital, Chien-Hua Huang, goes to work one day a week in cardiology (his first specialty), he sees 60 in half a day.
“But we have no choice: the price we are paid for each visit is so low that we have to see a lot of patients.”
A Taiwanese cardiologist who performs numerous surgeries can reach $40,000 per month, estimates Dr. Huang. A Taiwanese general practitioner earns from $5,000 to $10,000 per month, and an emergency physician from $10,000 to $20,000, in a society where the cost of living is slightly lower than in Quebec.
“ For my part, I never take more than 30 patients per half-day, because I want to spend 10 minutes with each of them. But hospitals don’t like us doing that, because it means they make less money… »
SPECIAL COLLABORATION PHOTO RÉMY BOURDILLON
Indeed, as hospitals compete for the budget fixed in advance by the NHI, they tend to pressure doctors to increase the number of consultations, explains emergency doctor Liang-Fu Chen, secretary general of an association advocacy group, the Taipei Doctors Union.
“Very often in Taiwan, a visit is limited to “Hello, are you okay? Perfect, then we continue with the same medication, until the next time,” he summarizes. But patients don’t complain about it, because they know that if their health deteriorates, they can at worst go to the emergency room where they will be seen immediately.”
“ As the health budget increases very little over time, we realize at the end of the year that we have worked more than the year before and that we have earned less. Because at the same time, society is aging and we find ourselves with increasingly serious cases. »
SPECIAL COLLABORATION PHOTO RÉMY BOURDILLON
Overworked nurses
Nurses are also overworked, to the point that Taiwan is beginning to be affected by nurse desertion, a scourge well known elsewhere.
“In Quebec, there are several levels: nurses, auxiliary nurses and beneficiary attendants,” recalls Pierre-Paul Therrien who worked for a long time in a CHSLD before becoming director of a bilingual school in the small town of Puli, there at 19 years old.
“In Taiwan, the same nurse will cover these three positions, with a salary closer to the beneficiary attendant.”
Montrealer Pierre-Paul Therrien, who lives in the small town of Puli, indicates that the role of nurses in Taiwan is very different from the one they have in Quebec.
Special collaboration photo Rémy Bourdillon
In fact, their pay is around $2,000 per month, which corresponds to the average salary on the island. Many therefore prefer to find another less stressful job, or to go and earn a better salary in Australia or the United States.
In the local culture, children were used to staying to sleep in the hospital to take care of their hospitalized parents, especially their hygiene.
“Nowadays, the Taiwanese have few children, and when they do, they are too busy with their jobs to take care of their mothers,” notes Doctor Liang-Fu Chen. So nurses have to compensate.”
Faced with the emerging shortage of nurses, hospitals have had to start closing beds. The low waiting times that are the pride of the Taiwanese health system are therefore starting to lengthen for those who must be admitted to hospital.
“Perhaps it is time for us to increase the share of our national wealth that we put into our health system,” concludes NHI director Chung-Liang Shih.