The $3 doctor visit

I spent all last weekend cooped up in my apartment, sucking down medicine and running through boxes of Kleenexes, trying to recover from a cold before Monday arrived. I was unsuccessful. So Monday morning, I went into work (I don't have a phone and the school is only two blocks away) to tell my coteacher that I probably shouldn't be around 100+ third graders while I have a cold. That was fine and everything, "just make sure to go see a doctor" she casually mentioned as I was about to leave. "Umm... do I have to? I'd really rather not spend that kind of money" I responded. She looked really confused. "Don't be silly, it's not that expensive" she says before walking into the classroom to begin the first class. So I head back home, not really sure what her definition of 'not that expensive' is, but slightly annoyed that I'm going to have to drop, I assume, at least 40 bucks on a doctor's visit.

But I'm letting you know now so I guess I kind of ruined it

I go to the doctor's office nearest my apartment and check in with the receptionist. I'm not really sure how the Korean healthcare system works and am wondering if there's going to be a bunch of papers to fill out and phone calls to be made before I'm actually able to see the doctor. Nope, just my Korean ID and she tells me to have a seat. The facility is nice and even has a flat screen television in the waiting room with a Korean soap opera showing. I can't make out what they're saying, but do you really need to understand the dialogue of a soap opera to be able to figure out what's going on? After just a few minutes of waiting, the doctor calls me in. It's a quick visit but he makes his diagnosis, writes a prescription for me, and has me sit in a room and breath this vapor in through my nose and out through my mouth. I go back out the receptionist, feeling that anxiousness that you get when you have no idea how much you're about to pay for something. 3,000 won she tells me. Wait... that must be missing a zero. 3,000 won is about $3USD. I ask her if she's certain. "Yes" she tells me, "3,000 won." I then go down to the pharmacy to get my prescription filled. "Okay, this must be where they get you. Cheap doctor's visit but then they charge a ton for the medicine. Like printers and ink." Wrong again. Six bucks for a bottle of Nasonex that normally runs $30-40 in the US.

"What in the world is going on?!" I ask myself. How was I able to go to a nice doctor's office, with English speaking staff, get treated quickly, and have a prescription filled all for less than ten dollars? I'm confused, skeptical, and extremely curious about how this works so I go into research mode when I get home. I discover that Korea has a single-payer healthcare system. A single-payer system which spends less than a quarter of what the US does per capita and produces better results (higher longevity and lower infant mortality rates).

Okay, so citizens must pay a ton of taxes for this super-nice, uber-cheap system, right?

Nope, employees pay 2.5% of their salary to the National Health Institute Corporation and the employer contributes another 2.5%. That means that an average Korean making $35K a year will pay $73 a month to the NHIC. Then, depending on the type of visit, the patient will pay somewhere between 10 and 30% of the treatment costs to the doctor, with a $2,000 cap on annual individual expenses (ie. the patient will never have to pay more than $2,000 in one year for treatment costs).

So doctors must not make very much money then, right?

This is actually kind of true. Doctors in Korea make about half of what a doctor in Europe or the US would make, but, by all accounts, they're still doing okay. In fact, the doctor's union has openly stated that they do not push very hard for price increases when negotiating with the NHIC because it would be "shameful for doctors to ask for more money when our profession is already one of the highest-earning in the country."

How about quality? Surely they have to sacrifice on quality, right? 

The fact is that, yes, there are many expensive treatments that the NHIC does not pay for. As much as people hate to hear the words 'rationing' and 'healthcare' in the same sentence, the truth is that every healthcare system, including privatized ones, must figure out a way to ration treatment. Even if there were enough doctors, nurses, medicine, etc. to treat everyone, a healthcare system which did so would immediately go bankrupt. So the NHIC has spent a lot of time studying different methods and have determined that there are many tests, treatments, and operations which are extraordinarily expensive and don't produce impressive enough results to justify the price tag. And they seem to be doing a great job; the Korean healthcare system has been ranked 8th most efficient in the world.

None of this in Korea

Doctors don't earn as much and the NHIC doesn't cover many expensive operations, but surely that's not enough to account for all of the savings, right? 

You are right indeed, my italicized friend; the vast majority of the healthcare savings can be attributed to the fact that it's a single-payer system. This cuts down enormously on administrative costs and, most importantly, it makes the healthcare system nonprofit, eliminating billions of dollars of profits which would be made in a privatized system.

One of the great things about the US is that we're usually open to importing good ideas from abroad. We may not come up with all of the great ideas, but we have historically been quick to adopt them and make them our own. "Hey, these French Enlightenment guys know what's up, we should use some of their ideas in our constitution." "Those Brits with all of their factories seem to be making a lot of money, maybe we should try that." And, most importantly: "That pizza stuff they got over in Italy is pret-tee delicious. We should try to make some of that here." But, for political reasons (or to take it one step closer to the root, monetary reasons) a lot of money has been pumped into fear-mongering about universal healthcare systems and the truth has been obscured from the American people. All you really have to do is look at the data, and in this case, the data is extremely clear: of the top 50 healthcare systems in the world, 49 of them have universal coverage. We are the only country that doesn't and we're ranked 38th, while spending way more than any other country. Hopefully one day, Americans will realize that universal health coverage is just as good of an idea as pepperoni pizza and that maybe we should think about importing it as well.