台灣醫療費，美國醫療費 Taiwan Medical Expense, U.S. Medical Expense

最近對 神的帶領有點掙扎，這時候記念 神過去的帶領（歌1:4, “稱讚你的愛情”，“稱讚”也可翻譯成“記念”）非常有幫助，每一次回想起祂過去的帶領，都是“幸好我當時順服了”，我常常不知天高地厚，還好 神一路耐心帶領。

Recently I have some struggle with God’s direction.  In time like this, it is really helpful to remember how He led me in the past (Song 1:4, “remember your love”).  When I recount His past guidance, my conclusion is, “Obeying Him is always the wisest thing to do.”  He is so patient with me who act like a spoiled brat at times.

之前在 Blog 曾寫過一篇“台灣醫生，美國醫生”，雖然只有中文，但是反應良好，點擊數很高，有些人若像我一樣怕痛的話，可能讀完之後，就會盡量選擇在美國就醫了。我也曾問過這個問題，美國醫療比較不痛，又不用和妻子孩子分開，神 為什麼要帶我回台灣呢？

I wrote a blog “Taiwan Doctors, U.S. Doctors” before and the response was pretty good, even though it was only in Chinese.  If you are like me who have low pain intolerance, you will probably choose to get medical attention in the U.S.  I asked Him the same question, why did You bring me back to Taiwan?  If I get treated in the U.S., it will be less painful and I don’t have to be separated from my wife and kids.

這個問題的答案，當慧玲阿姨把我們在美國的醫療賬單寄來的時候，就有了一些眉目。我在美國沒有保險，但申請到醫院的愛心補助金，所以所有醫院的費用全免，只需要付醫生的費用。我在美國做的總共就是：一次急診，一個腸鏡，再一個電腦斷層。

I had a glimpse of the answer to this question when Huilin forwarded my medical bill in the U.S.  I don’t have medical insurance in the U.S. but got approved with Charity Discount from this hospital so every hospital expense was waived.  I only had to pay the doctor fees.  This is what I did at the U.S.: ER, colonoscopy and a CAT scan.  

美國的賬單大概是這樣：急診和住院不到12個小時，基本帳單是 $5900+，愛心補助金付清了這$5900+；但是還是要自費急診醫生 $601、腸胃科醫生探訪 $140 （才講了不到10分鐘…），急診時做了一次電腦斷層，要付外包的電腦斷層機構 $450，另外，還一個醫生也來和我談過，急診和住院時各抽了我8捅血（急診和住院時各4桶），這些帳單還沒有看到，不知道愛心補助金會不會搞定？！腸鏡不到半個小時，四個費用：腸胃科醫生$450，化驗$330，麻醉醫師 $800（就算麻醉醫師容易被告，也不用比醫生還貴近一倍吧），場地費$770（這還是比較便宜的小場地，若是在醫院裏面做腸鏡，光場地費就要$3500到 $7000，而且這只是場地費，不包括腸鏡前後的住院費和醫生護士等等費用）。最後，腸鏡後的電腦斷層，結果雖然醫院費用全免，但還要付 $649給外包的電腦斷層機構。所以目前看到那兩個星期在美國的賬單：急診 $1191，腸鏡 $2350，電腦斷層 $649。

Here is the U.S. bill: The initial bill of ER and hospital (in there less than 12 hours) is $5900+, which is covered by the Charity Discount.  However, I have to still pay the ER doctor $601, gastrointestinal doctor visit $140 (she spoke to my less than 10 minutes…), CT Scan (outsource radiology company) $450.  Besides these, I recall that there was the hospital residence doctor (not ER doctor) who I spoke to and they drew 8 tubes of my blood (4 tubes for ER, 4 tubes for the hospital).  I haven’t seemed these bills yet.  Will the Charity Discount cover all these fees?  The four fees for the Colonoscopy (actual process less than 30 minutes) are: gastrointestinal doctor $450, pathology $300, anesthesia doctor $800 (okay, they get sued often, but do they have to charge almost double comparing to the doctor?), and facility fee $770 (This is a small private clinic.  If I do it at the hospital, the facility fee alone ranges from $3500 to $7000, which does not include extra doctor or nurse fees before or after the colonoscopy).  Finally, the CAT scan is $649 to the outsource radiology company.  So for those two weeks, the known bills in the U.S. are: ER $1191, colonoscopy $2350, CAT scan $649.    

我在台灣有健保，這也是三、四年前有一次我回台灣時搞丟了台灣護照，所以必須復籍，就開始自動有健保，今年四月回台灣服事，跑去繳了所有的健保費，想十一月再回來服事時，去照個腸鏡，沒想到我五月就在美國急診，發現有腸癌。我在台灣這兩個月，住最好的病房8天，重照了腸鏡，做了腸胃X光鏡、電腦斷程、正子分析檢查、人工血管、電療28次、化療4次、電療醫生回診5次、看過主治醫生10幾次。這樣一堆醫生場地藥物的費用加起來不到台幣5萬塊，又因為醫生幫我辦理了“重大傷殘”，所以又豁免台幣2萬多，最後這兩個月的賬單出來不到3萬台幣（大都只是病房的費用，也就是說我若是當時住差一點的病房，幾乎就會全部免費），折合美金不到$1000。

I have the national health insurance in Taiwan.  It is because I lost my Taiwan passport once three, four years ago so I had to reinstate my Taiwan residency which comes with the national health insurance.  I paid all the insurance fees this April during my ministry trip, thinking I will probably get a colonoscopy when I come back again in November.  Then I was diagnosed with colorectal cancer in May and I came back a lot early than I expected.  In the past two months being here in Taiwan, I stayed at the best hospital room for 8 days, did a colonoscopy, gastrointestinal X ray, CAT scan, PET scan, port A, radiation therapy 28 times, chemotherapy 4 times, radiation therapy doctor visit 5 times, oncology doctor visits over 10 times.  All these medical expenses added together are less than NT50000 (@U.S. $1667).  Because I am qualified as “critical ill”, some of my expenses were waived, so the actual medical bill for the past two months is less than NT30000 (less than U.S. $1000), which could be mostly avoided if I stayed at a cheaper shared room.

這兩種醫療費用，實在差太多太多了。當時禱告很清楚，知道 神要我回台灣治療，雖然心裏有些不願意，和其他一些事情的考量，但是放下一切順服了，我當時不知道醫療費會差這麼多，只是單單地相信祂而順服。現在回想，真的是幸好順服了。假如我傻傻地執意要留在美國就醫，那醫療費就算有愛心補助金，也可能是個天文數字，足以讓我這個禱告宣教士傾家蕩產。結論還是，要花大量的時間聆聽 神、順服 神，真的值得。有時雖然不明白，有時心裏需要時間伏下來，但是祂的帶領總不會錯的，祂是好牧者。

I am pretty astonished to see the difference of these two medical bills.  When I knew clearly through prayers that God wants me to come back to Taiwan to get treated, I had my hesitations and concerns.  I had no clue how the medical expense will play out but I obeyed Him out of believing Him.  Thank God that I obeyed Him.  If I was stubborn and chose to stay at the U.S. to get treated, I will be broke pretty soon even with Charity Discount.  My conclusion is again that investing a lot of time to listen to Him and to obey Him is truly worth it.  Sometimes I don’t understand Him.  Sometimes I need time to surrender to Him.  But His guidance is never wrong.  He is the good Shepherd.