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On Friday night, as I was slowly handshaking my way out of a goodbye party for a friend, I grabbed a couple of macadamia nuts out of a dish to munch. A few minutes later, I noticed that my mouth and tongue were starting to swell.

While I had never had an allergic reaction in my life, I was about to join the thousands who probably go off to an emergency room unexpectedly every day. But my reaction was taking place in Hong Kong, a city that, according to the conservative Heritage Foundation, ranks No. 1 for fang-and-claw capitalism and has for perhaps a dozen years been at the top of the foundation’s Index of Economic Freedom World Rankings, except when it changes place with Singapore.

Nonetheless, what would happen to me over the next three hours ought to inform the debate over health insurance that is now racking the US Congress and threatening Barack Obama’s presidency. Congress was to vote on Sunday, Washington time, on Obama’s latest plan, a last-ditch effort to save one of his key reforms — providing heath care to uninsured Americans.

The Heritage Foundation is one of those right-wing lobbies that are waging a last-ditch fight against the president’s plans. Of the Heritage Foundation’s top 10 countries in its index of economic freedom, however, every single one has some system of universal health care except for the United States. Freedom of universal health care obviously does not figure in the Heritage Foundation’s definition of economic freedom.

Back at my friend’s apartment, by the time I got to the street, I could feel my hands and feet start to swell. I hopped onto one of the city’s rattletrap trams to go the 15 or so blocks home, thinking I ought to get there fast and go to bed. But on the tram, I started to feel like I was being bitten from head to foot by fire ants.

I alighted from the tram at my stop, intending to walk the three blocks home when I could feel my throat starting to constrict. This is not good, I thought. I jumped into a passing taxi and asked to be taken to the nearest hospital — about 400 meters away. It was Ruttonjee Hospital, a 140-year-old onetime tuberculosis sanitarium that was redeveloped into a 600-bed general facility in 1991 and remains partly government funded.

Ruttonjee is emblematic of Hong Kong’s medical infrastructure, which consists of parallel medical systems that feature 12 private hospitals and more than 50 public ones. Polyclinics also offer primary care services, including dentistry. Most universities offer free or affordable health care to students.

According to a paper by Kar Neng Lai and Wai Kei Lo of Queen Mary Hospital at the University of Hong Kong, only 10 percent of the population have health insurance or receive health benefits from their employers. The government spends 2.97 percent of GDP for public health services, which cover 92 percent of all hospital admissions. Private care is about as expensive as it is in the United States, with private patients spending 1.8 percent of GDP on private care, or 40 percent of total health spending.

US health care spending amounts to 17 percent of GDP. Health care spending also triggers 62 percent of all personal bankruptcies, according to studies by Harvard University and the American Journal of Medicine.

Despite the fact that 92 percent of the public get their health care from state-run institutions, Hong Kong is one of the healthiest places on the planet. That is partly — at least according to the government — because of its health education and professional services.

Within minutes after the terrified taxi driver dropped me panting and gargling at the doors of Ruttonjee, I was on a gurney, being given medication. The check-in procedure involved handing my permanent resident identification card to the admissions counter. Admission also features payment of 100 Hong Kong dollars ($13). That was it for three hours of care including an electrocardiogram, saline drip with antihistamines and steroids, expert care and five days worth of medication.

While for me it was an emergency, for the hospital it was utterly routine. There was no need to hand over a credit card, no need to fill out a series of forms. In the United States, such treatment is simply unthinkable. According to Consumer Health Ratings, a US-based Web site, a typical emergency room arrival in the United States costs $1,038. An EKG can run to another $1,375. Anyone going to a publicly funded US emergency room faces hours of waiting unless they suffer from an immediate life-threatening condition.

There were no bills for me to sign at Ruttonjee. When the nurse woke me, she asked me if I wished to spend the night. Since I only live half a kilometer from the hospital, I got up and walked home minus a 100 Hong Kong dollar bill along with 20 Hong Kong dollars for the taxi ride.

 

John Berthelsen, who is from California, is the editor of asiasentinel.com, a Hong Kong-based Web site.