Kidney Stoned in Taipei: My Emergency Sojourn at Veterans Hospital

It’s high on every expat’s nightmare list – needing emergency medical care in a country where you’re an outsider and don’t speak the language beyond telling a cab driver where to turn.

I was home alone, my wife and children off visiting family in the UK, when I was struck with a sudden, searing pain in my abdomen, feverish sweats, and the urge to vomit and defecate simultaneously. Every internet search result turned up appendicitis and all recommendations were consistent: seek emergency care.

I called a friend fluent in Chinese and begged him to call me an ambulance. When it arrived, the ambulance team asked me, “Are you the person who called for an ambulance?” Engulfed in my suffering, I answered “No,” since I wasn’t the one who actually made the call. As they turned back to their vehicle as if to leave, I cried out in my lousy Mandarin, “Wait!” They turned back to me as I bent nearly double and grasped my gut in pain. “Are you the person who called for an ambulance?” they repeated. “Yes!” I replied. Satisfied I wasn’t faking, they took me in.

The ambulance ride down our steep, winding mountain road was a painful comedy of errors. I writhed and moaned on the gurney while medical supplies tumbled off the shelves during our twisty descent. The attendant, limited in his English skills, did his best to take care of me. I tried to explain that I felt the need to vomit but he didn’t understand, so I mimed a powerful expulsion. But once I had a bucket under my chin, nothing would come out. Arriving at Taipei Veterans General Hospital, I requested the bathroom with the same result while both urges remained undeniably strong.

The hospital atmosphere was rough around the edges and very public. I waited on my gurney in a large room, exposed to the other sufferers in the ER on that Saturday morning. The pain came and went in waves, but when it peaked, I squirmed and moaned like a spoiled brat throwing a tantrum. No one else made a sound other than low murmured conversation.

The others glanced at me, but most were too polite to point or stare. As an expat, your behavior is often viewed as representative of your country’s entire population, and surely they deduced from my histrionics that Americans are weak, prone to tears and screaming.

An ER technician took my vitals as I described my symptoms. They narrowed it down to appendicitis or a kidney stone. The former required emergency surgery, the latter required merely waiting for the stone to pass.

The physician who treated me spoke fluent English and had a bedside manner that was warm, reassuring, and supportive. The staff was professional, courteous, and highly skilled — lacking nothing I might expect in America. Next stop, a CT scan to get a look at my insides. Then we waited for an interpretation by the radiologist on duty. We also needed a urine sample, but that was another issue as I was dehydrated.

Though this was one time when it possibly did, I couldn’t pee if my life depended on it. I asked for water, but it wasn’t allowed in case the problem turned out to be appendicitis and I would need to have an empty stomach for emergency surgery.

So we waited until I felt like I could provide a sample. And when I did, lo and behold, there in my urine sample rested the offending stone. The endocrinologist congratulated me: “You have a very efficient urinary system. People can take weeks to pass a stone.” I admit to feeling a bit of pride along with the relief.

Soon able to be discharged, I prepared to face the bill. There were two columns – one indicating the costs if you have Taiwan’s National Health Insurance, one if you don’t. The total without insurance was NT$11,000 – just over US$350. With insurance it was only NT$750 – a grand total of US$25. I silently blessed my National Health coverage and dug the required cash from my pocket.

A bit of research reveals that in the U.S. the ambulance ride alone could be over US$1,000. A CT scan can run up to US$3,000. All told I was there for about six hours, and the average cost for a day in the hospital is US$4,700. The total bill without insurance in “the greatest country in the world” could have been US$8,000-$10,000. Comparing that to US$366 or the US$25 I paid, I’m convinced Taiwan’s system is better. Quality care, expertly provided at a price that won’t bankrupt even the uninsured.


  1. There’s no free lunch. Several things dictate your cheap healthcare experience in Taiwan, the massive difference in economies (everything is cheaper in Taiwan except some real-estate in major cities), the debt your doc visit saddled the country with. Not to mention the heavily overworked healthcare professionals in Taiwan that typically put in 14 hour days of grinding work at the office in order to make a good working way. I know docs in Taiwan and the US, and some docs which work in both countries. They tell me that the work life for a doc or medical staffer in Taiwan is brutal, you have to see a multiple more patients over much longer hours in Taiwan in order to make a good living, the cheap care must be made up for in volume and it comes right from the docs blood sweat and tears. Taiwan’s National Health Care insurance is going bankrupt and huge changes will be made soon. Same thing occurred in England and any other country attempting to dole out cheap care. Someone has to pay for it, and they always do, either through the government ratcheting up taxes which in turn slow the economy, or very high insurance premiums and co-pays by the individual. Don’t be naive, it’s not a better system, you simply experienced a huge money losing government program that’s about to change, the Taiwanese government is carrying the loss with Taiwanese tax payers money and government debt which will also eventually have to be paid by the next generation.

  2. I’ll admit you’re right if and when the changes you predict occur. Regarding a free lunch, a reasonably price lunch is much more palatable and realistic. And striving to keep for-profit players out of the system means less money feeds high quality food to more people.

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