I never quite imagined that my trip to South Korea would afford me the chances to experience the Korean medical system in a short month. I had, in fact spent time shadowing doctors both in the Emergency Department and the General Surgery Department of a South Korean hospital (edited for anonymity).
South Korea provides its citizens with a general sort of institutionalized healthcare. Basically, every South Korean citizen who pays their taxes is given an government sponsored insurance plan for healthcare. This entitles them for hospital stays, emergency room visits, and various other needs such as medicinal and outpatient coverage.
The benefits are all included within the plan and there are small out of pocket payments that you have to make when you visit a health care establishment. Surprisingly, the system works and it works relatively well. Of course, given South Korea's relatively homogenous population and similar prevalences of disease it is easy for a government sponsored health care plan to effectively address the needs of its population.
However, I saw a few cases that really blew my mind. I saw a lot of the run of the mill trauma that comes in due to fights, accidents, traffic accidents, and other bloody incarnations of what people can do to themselves - I did see my fair share of suicides and near suicides.
Many people who found themselves being resuscitated on the table usually drank enough pesticide or herbicide to kill a whole field of whatever. The irony of poisoning yourself or killing yourself is that you default on your government sponsored health insurance. Your family often ends up paying for a failed suicide, people who are left comatosed and unable to take care of themselves.
The government shifts the bulk of the responsibility to the family. I asked some of the chief residents and attendings how families end up paying for the bills, loans, they surmised, unsure of how that really can afford hundreds of thousands of won in debt.
Aside from suicides and trauma, doctors in this hospital really take care of their patients. Hospital stays are only around 10,000 won a day, which after the exchange rate is only around 10 bucks a day. People end up staying a while and being looked after. There certainly are cultural differences in the way people approach healthcare, but that's for another entry.
Saturday, August 18, 2007
Ajou University Hospital and Reflections on a Trip to South Korea
Sunday, April 22, 2007
Asian American Mental Health, a Reflection
Minutes passed as I kept refreshing the page I was on on April 16th. Trying to gauge the brutality of what was going on at Virginia Tech and later trying to understand the expanse of what it meant for me. It's been almost 6 days and I still don't really have an answer. However, while I read about this guy, I realized that I read about him before.
The anger, the confusion, the reaction - the story was familiar. It could have been about the guys I knew growing up in high school. The same story could have been about a few kids in my alma mater. As an Asian American, I'm sure we have known of a few kids just like Seung-Hui Cho. The question of why Cho slipped through the cracks remains a mystery for me.
As a Asian American guy, I struggle with the idea of mental illness. I've known friends who discuss issues with me about feeling angry, sad, misunderstood by parents and peers. I've had friends who talked about suicide. Some folks I know read like the Diagnostic and Statistical Manual of Mental Disorders (DSMMD) and some in fact, are Asian American .
We live with a difficult culture, especially in the light of immigration and a generation gap. A few of our parents grew up without the ideas of bipolar disorder, alcoholism, depression, manic-depression, and personality disorder. Many of these are not just endemic in youth culture, but found within pop culture. Yet, the discussion of mental health counseling for folks in our community is often encountered with silence and deflection.
It is unfortunate that Seung-Hui Cho became the focus of the Asian American community. He also became an argument with the increasing number of Asian American medical students that there is a need for counselors, psychologists and psychiatrists to address the issue APIA mental health. Asian American clinicians can directly address cultural and race specific issues that other people may have a hard time relating with and resolving with Asian Americans.
Just maybe, we can find kids like Seung-Hui Cho and prevent another tragedy. Here's to hoping for a change.