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My Experience with the South Korean Healthcare System

It started out as a cough… a week before Christmas. Finals had just ended and I had caught a cold. It was just one more week till I flew to South Korea to spend my winter break with my girlfriend, Amy, who has been teaching English there. Having spent the very hot month of August there with her, I assumed I would try the other extreme the winter provided. The day after Christmas I was on a direct 16 hour flight from JFK to Seoul/Incheon airport popping rolls of cough drops to suppress the remnants of my cold – now just a rough cough. I had finally started feeling better and I felt incredibly relieved because we have had to spend so many months apart and I hated the idea of being sick for this trip.

Well, stupidly I’d been out running all over Seoul in the cold for much of my trip without the right amount of layers. We enjoyed all the outdoor markets, coffee shops, museums, parks, and restaurants, all the while braving the cold extremes of a Korean winter. It was freezing most nights, about 14 degrees on average. The largest snow fall in the last 40 years fell in Seoul which just under 1 foot. The country was largely unprepared, with no plows and many shop owners using brooms to push snow around. Walking through the slush wasn’t fun but the culture and beauty of the country made you forget the cold (so did a few beers).

My cough grew worse until I was coughing up mucus frequently. I’d be congested, started getting headaches, and then would run a fever at night. The cough grew worse until it felt like my lungs were cut up. I was increasingly miserable. I needed to see a doctor. What was my first thought? How much would it cost to see a doctor here? How easy would I be able to see a doctor without insurance? I put it off one more day until that night my teeth throbbed from the congestion in my head.

The next morning, I took 400,000 won out of the ATM (about $375) and walked to the nearby university hospital in town. Amy lives in Sanbon, about an hour south of Seoul, in a really nice studio apartment her English academy provided her with for the year. Sanbon is a really great area, there is always a lot to do downtown and there are tons of shops and restaurants stacked on top of each other. Around the corner was the hospital but because this area is pretty far removed from the city, I wasn’t expecting an English speaking hospital.

At the front desk, the woman did not speak English, but realized I was pretty sick. “Swine flu?” she asked nervously. “Anio,” I said, ruling that out after checking my symptoms online. A woman was walking by noticed the difficulty we both were having with the language barrier and offered to translate for us. She wrote my symptoms down in Hangeul and handed it to the woman at the desk and after a quick look she pointed me to the 2nd floor. As I made my way to the escalator, the translator followed me up. “They probably won’t speak English at this hospital, I’d be happy to help you out since I have a lot of free time today,” she said. I looked down at her hand and noticed a bandage covered the mark an IV had left there. She had just had an MRI and had for headaches she’s had been having she told me.

Her name was Su-Jin, she had lived in Canada for two years studying Political Science and learning English. She was a life saver and good company, considering she had wanted to practice her English which she hadn’t used in years and I was really interested in hearing all about Korean politics. We headed over to check in at the desk. “You must pay to see a doctor,” she said. The hospital had an efficient layout with a large waiting area surrounded by doorways to different doctor’s offices categorized by their specialty with their assistants’ desks in front of the doorways handling patients.

“Name and birthday, please,” the receptionist said. I typed my name into the computer which was translated into Korean. “Okay, a foreigner without insurance… that will be 11,000 won to see the doctor.” (That’s about $9) Shocked, I paid and took my seat in front of my doctor’s office. Su-Jin kept me company explaining that since it was so busy I’d have to wait two hours to see the doctor and that she would wait with me and help translate. We talked for the two hours about life and politics in America and in Korea. In the very early morning, Su-Jin worked in Dongdaemun as a reporter for YTN (Korea’s CNN).

Looking around, the hospital was a sea of people surrounded in large screens with our names and wait times or Korean television (which when I had the opportunity to watch it, usually consisted of famous Korean actors eating spicy foods and people laughing at them). The most annoying part of the waiting experience was the cleaning crew that kept mopping the clean floor around us. Su-Jin explained that South Korea has a universal system of healthcare which mandated coverage to everyone in 1988. Their government is the primary payer to hospitals. Doctor’s fees and insurance benefits are standardized. In fact, Korea is ranked by the World Health Organization as being 38th in the world in overall healthcare, while the United States is ranked 37th. “There are always some complaints, but on a whole, the system has always been good to me and my family,” Su-Jin told me.

We eventually were called in to see the doctor. Around the reception desk of that portion of the second floor was his office next to several other general practitioners. Inside, there was the traditional bed with the sheet of wax paper over it and his personal desk and computer. I was surprised the office was an all-in-one room. So they actually see and treat their patients inside their office.

Su-Jin translated everything as we discussed what my problem was. “In the interest of saving you some money, I think we should either do blood work or an x-ray of your head and chest to determine your problem,” the doctor explained. “It sounds like walking pneumonia or bronchitis.” Here is where I would pay a lot more money, I figured. Not being a fan of needles, I opted for the x-ray approach and went to the 3rd floor for my x-ray. They scanned my head and chest, wrote me a prescription of cough medicine and decongestant to hold me overnight, and scheduled me the next day to review the results with the doctor.

On the way out, I thanked Su-Jin and asked to buy her a cup of coffee at the nearby Starbucks. We talked some more over coffee and she invited Amy and I to a dinner with her and her husband at their house, just around the corner where Amy lives, over the weekend. Also, she said she’d meet me at the entrance at 2:30pm for my appointment to help translate again. I was blown away by her generosity.

The next day, I headed back to the hospital for my results. When I entered the building Su-Jin appeared and led me back to the doctor’s desk. I handed the receptionist my appointment slip and we were taken right in to see the doctor. He should me the x-rays of my head and chest on his computer. He recommended I see another doctor to have my sinuses and esophagus looked at. We went upstairs, went right in to see the new doctor right away.

Finally, we sat on deck while this young Korean girl sat, horrified, in a creepy well lit steel chair. Peering over the cubicle-like wall from the waiting seats, Su-Jin and I saw this rather scary looking doctor take this long metal prod and run it in and out of this girl’s nose vigorously. This long thin metal straw made a hissing noise like an air gun inflating a tire. Her eyes swelled, her face turned red, and mist began to shoot out of her mouth. She began to squirm and cry from the short discomfort. It looked horrible. Su-Jin looked more worried than I was for what was coming my way, but the pain and discomfort of my own condition numbed me from the fear of what we were witnessing.

The young girl walked passed up wiping away the tears and the doctor pointed at me over the wall. “Dangsin-eun da-eum,” the doctor said sternly, informing me I was his next happy customer. I sat in his cold seat as he adjusted his equipment and the near blinding light. He turned to me humming a song with a 1950s-horror-movie-doctor’s reflecting disc over one eye and tilted my head back. Su-Jin walked over and stared at me with a grossed out but curious look on her face. “We should have brought popcorn for this,” I said. The doctor slipped the long metal prod into my left nostril and pressed the trigger and instantly I felt my ears pop violently, my eyes felt like they fell back into place, and I noticed the fluid running in and out of my nose from the tube connected to his snot-prod. In and out, now the right nostril, finally spraying a mint mist into my mouth. I felt like Tom Wilkinson’s character in the movie Michael Clayton (except I wasn’t being killed, quite the opposite).

For the first time in weeks I felt amazing, almost instantly. Next, he held my tongue out with a piece of cotton and took a long super thin fiber optic camera with a light and sent it down my esophagus and turned me to look at my larynx on the bid screen, in glorious HD. “Ah ha,” the doctor exclaimed. “You have acid reflux disease it looks like on top of laryngitis and some bronchial swelling.” (Having suffered from stomach problems for years and years, I now knew what the problem was, when doctors had told me to just change my diet which was pretty modest to being with.) He pulled the camera out painlessly, and turned to his computer, punched a few keys in and turned to give me his printout for the prescription I needed. “A 4 hour IV or a week worth of pills?” he asked. I went with the pills.

Feeling better than I had in a month, Su-Jin and I headed to the reception desk to pay for everything since the doctor visit from yesterday. How much were the x-rays? 25,000 won (about $21). The fiber optic endoscopy and nasal vacuuming? Free because it was included as part of the initial doctor visit for 11,000 won ($9). A week worth of pills, easily pre-sorted in packs for breakfast, lunch, and dinner? 30,000 won ($25). So all in all, what would have likely cost me several $100s at least in the States even with insurance (probably over $2000-3000 without), cost me only $55 in Korea. I was given better care as an uninsured foreigner than I’ve ever been given in any doctor’s office with insurance here in America. I was treated with respect by the doctors and even the creepy snot doctor was very friendly and happy to help me out. If it weren’t for their health care system and the quality of care I received, I probably wouldn’t have been quarantined at the airport with a fever, unable to fly home in the condition I was in.

Did I mention I got a great new pair of glasses for 30,000 won ($25) and only had to wait 30 minutes after a laser reading of my eyes to pick them up?

We need something like this in America — our own version of a universal system. One that is not about profit but need. The current health care system in America bankrupts people who get sick and need care but can’t get insurance because of a pre-existing condition or even if they have insurance it can be too expensive an already tight budget to handle. We have absolutely nothing to fear from a system such as this, if we’d at least examine universal coverage as a real possibility.

"I do not want to talk about what you understand about this world. I want to know what you will do about it. I don't want to know what you hope. I want to know what you will work for. I don't want your sympathy for the needs of humanity. I want your muscle." - Robert Fulgham