A life of influence: what a leading surgeon learned as a patient

When illness forces a trade-off between health, time and money, how do we choose well? Most people hit by a sudden serious illness feel overwhelming uncertainty and financial panic before they feel any physical pain.

This episode of Pills and Bills welcomes Dr. Tu Yuan-kun, superintendent of E-Da Hospital. He speaks from two vantage points — a leading orthopaedic neurosurgeon, and a patient who has been through serious illness three times — on how understanding medical choices and building assets and a long-term care reserve lets people secure more dignified care and more financial flexibility when a health crisis comes.

When the doctor becomes the patient

For years Dr. Tu has given most of his salary and investment returns to charity and foundations. Yet within six years he faced three serious illnesses: a ruptured knee ligament, a 90% coronary artery blockage, and a diaphragmatic hernia with severe gastric adhesions.

• Seeing through the patient's eyes: going from department head and superintendent to the person on the operating table, he learned that what patients want most is for the doctor to be a little kinder and say a few more words to them.
• Reordering priorities: he used to rank influence first, then money (earned to help others), then time. Facing doubts about how much time remained, the order became time, money, influence — doing good while he still can, arranging trusts and the foundation's long-term operation, and passing medical knowledge on to his students.

Cost, price and value

With self-pay care and expensive devices increasingly common, Dr. Tu advises against rushing to a decision and suggests weighing three things:

• Cost: the published fee for a device or procedure.
• Price: the difference in outcome when the same material is used by physicians with different experience and skill.
• Value: does this treatment genuinely improve quality of life, and is it reasonable within your own or your family's means?

National health insurance provides a solid baseline of acute care that keeps people alive, he stresses. Going beyond that for quality of life or dignity means seeking opinions from different physicians, talking care plans through with family, and assessing what you can afford.

Planning assets for medical and long-term care

Against the financial pressure of serious illness, Dr. Tu's advice is to have the umbrella ready before it rains. Alongside national health insurance, personal asset planning and private insurance are key:

• A health budget: Dr. Tu suggests an ordinary household keep at least 50% of its assets as a medical and long-term care reserve — not just for acute treatment, but for the large self-paid costs that follow: caregivers, care facilities, assistive devices and nutrition.
• Read the policy terms: check exactly what a private policy pays for — whether it is limited to accidental injury, whether it covers newer minimally invasive procedures and other self-pay items — so your cover keeps pace with medical progress.
• Invest in prevention: rather than spending heavily on acute treatment and long-term care after the fact, move resources upstream to prevention through exercise, diet and routine.

Precision, quality, and complementary private insurance

Looking ahead, Dr. Tu believes hospitals must move away from volume for its own sake toward precision, refinement and quality. Tiered care and remote consultation can filter out unnecessary tests so physicians can focus on patients who need precise treatment, raising quality and patients' sense of being respected. And as self-pay items grow, private insurance working alongside national health insurance will become the norm, giving people more — and better protected — options when a health crisis arrives.

Facing an unpredictable future, his advice to everyone is simple: cherish life, and plan it. Prevent while healthy, and use medical and insurance resources wisely when needed, so that you and your family can live healthily and with dignity.

Pills and Bills unpacks the real problems that begin after diagnosis, every week.