Clipping Board » Medical Affairs and Administration ─ Medical system, pharmaceuticals, and medical community-related reports
NOWnews – June 22, 2012
Reporter Chen Kunkai / Taipei Report
Taiwan's National Health Insurance (NHI) system, often likened to an "all-you-can-eat" buffet, enjoys a domestic satisfaction rate of over 88% and is the envy of many internationally. However, Chen Ming-feng, Superintendent of National Taiwan University Hospital, criticized the system at a forum today (22nd), stating that while it provides great convenience for public healthcare access, it has a "rotting from the roots" detrimental impact on medical education.
The forum, titled "Comprehensive Review of Taiwan's Biotechnology and Healthcare Industry Policies," was hosted by the National Biotechnology and Healthcare Industry Promotion Association. Chen Ming-feng pointed out that Taiwan's NHI system fosters a "take as much as you want" mentality among the public. Yet, with the current NHI budget accounting for only 6.6% of GDP, this is simply unsustainable and has led to severe distortions in the healthcare ecosystem.
Should the NHI focus on meeting the most basic healthcare needs for all or prioritize medical relief for major illnesses? Chen Ming-feng argued that the fundamental principles of the NHI system remain unclear. It covers both advanced, expensive medical procedures and routine minor ailments, attempting to balance both. To achieve this, the system suppresses reimbursement rates for individual medical services and undervalues the labor costs of healthcare professionals, merely to maintain NHI financial balance.
For instance, the reimbursement for seeing a patient in dermatology or ENT (ear, nose, and throat) is the same as that for oncology, which involves extensive consultations and physical examinations. Chen Ming-feng noted that this naturally drives medical professionals toward lucrative fields like cosmetic medicine ("five-sense specialties"), while demanding specialties such as internal medicine, surgery, obstetrics and gynecology, pediatrics, and emergency medicine—requiring night shifts, long hours, complex tasks, high risks, and frequent disputes—have become the "five major empty specialties."
Chen Ming-feng criticized the NHI's flat-rate reimbursement across different specialties as the killer distorting the healthcare ecosystem, causing medical education to "rot from the roots." Even after completing hospital training, many young doctors opt for clinics without night shifts or private practices, attracted by higher incomes, no on-call duties, and lower risks.
Beyond criticism, Chen Ming-feng offered concrete suggestions, urging the government to increase the NHI budget and abandon the flat-rate reimbursement principle. This would allow more NHI resources to be allocated to life-saving medical practices, encouraging or attracting young doctors to these specialties.
Cheng Shou-hsia, former Director of the Bureau of National Health Insurance and current Director of the Institute of Health Policy and Management at National Taiwan University, highlighted another concern. She noted that while Taiwan's elderly population (aged 65 and above) accounts for about 11% of the total population, they consume 34% of NHI medical expenses, with a 121% growth over the past decade. According to the Council for Economic Planning and Development's projections, Taiwan's population will begin to decline by 2022, leading to even faster growth in medical expenses—a major reason for the NHI's financial shortfall.Source: http:/ / tw. news. yahoo. com/ % E5……5% 99% E8% 82% B2- 090406939. html;_ylt=AnbXu1A0PyeL2P5K.BxudHSUBdF_;_ylu=X3oDMTRlcTY3ZG5kBG1pdANUb3BzdG9yeUZQIEFydGljbGVTZWN0aW9uTGlzdARwa2cDYzQyZmQ1YzMtYmJkMC0zNDYxLWE2YjMtZGVkODIxYjBmNGY0BHBvcwM2BHNlYwNNZWRpYVNlY3Rpb25MaXN0BHZlcgM3NTRhNGI2OS1iYzU5LTExZTEtYWFmNy1mN2JhODIwYzdhNGQ-;_ylg=X3oDMTJvb2J1bnFtBGludGwDdHcEbGFuZwN6aC1oYW50LXR3BHBzdGFpZAM4NmIzZWY5Yy02MTVjLTNkOWUtYmNkNi03N2FmZDQzN2UzMGQEcHN0Y2F0AwRwdANzdG9yeXBhZ2U-;_ylv=3
Rooted in Decay! NTUH Director Slams All-You-Can-Eat Healthcare for Ruining Medical Education
Reporter Chen Kunkai / Taipei Report
Taiwan's National Health Insurance (NHI) system, often likened to an "all-you-can-eat" buffet, enjoys a domestic satisfaction rate of over 88% and is the envy of many internationally. However, Chen Ming-feng, Superintendent of National Taiwan University Hospital, criticized the system at a forum today (22nd), stating that while it provides great convenience for public healthcare access, it has a "rotting from the roots" detrimental impact on medical education.
The forum, titled "Comprehensive Review of Taiwan's Biotechnology and Healthcare Industry Policies," was hosted by the National Biotechnology and Healthcare Industry Promotion Association. Chen Ming-feng pointed out that Taiwan's NHI system fosters a "take as much as you want" mentality among the public. Yet, with the current NHI budget accounting for only 6.6% of GDP, this is simply unsustainable and has led to severe distortions in the healthcare ecosystem.
Should the NHI focus on meeting the most basic healthcare needs for all or prioritize medical relief for major illnesses? Chen Ming-feng argued that the fundamental principles of the NHI system remain unclear. It covers both advanced, expensive medical procedures and routine minor ailments, attempting to balance both. To achieve this, the system suppresses reimbursement rates for individual medical services and undervalues the labor costs of healthcare professionals, merely to maintain NHI financial balance.
For instance, the reimbursement for seeing a patient in dermatology or ENT (ear, nose, and throat) is the same as that for oncology, which involves extensive consultations and physical examinations. Chen Ming-feng noted that this naturally drives medical professionals toward lucrative fields like cosmetic medicine ("five-sense specialties"), while demanding specialties such as internal medicine, surgery, obstetrics and gynecology, pediatrics, and emergency medicine—requiring night shifts, long hours, complex tasks, high risks, and frequent disputes—have become the "five major empty specialties."
Chen Ming-feng criticized the NHI's flat-rate reimbursement across different specialties as the killer distorting the healthcare ecosystem, causing medical education to "rot from the roots." Even after completing hospital training, many young doctors opt for clinics without night shifts or private practices, attracted by higher incomes, no on-call duties, and lower risks.
Beyond criticism, Chen Ming-feng offered concrete suggestions, urging the government to increase the NHI budget and abandon the flat-rate reimbursement principle. This would allow more NHI resources to be allocated to life-saving medical practices, encouraging or attracting young doctors to these specialties.
Cheng Shou-hsia, former Director of the Bureau of National Health Insurance and current Director of the Institute of Health Policy and Management at National Taiwan University, highlighted another concern. She noted that while Taiwan's elderly population (aged 65 and above) accounts for about 11% of the total population, they consume 34% of NHI medical expenses, with a 121% growth over the past decade. According to the Council for Economic Planning and Development's projections, Taiwan's population will begin to decline by 2022, leading to even faster growth in medical expenses—a major reason for the NHI's financial shortfall.Source: http:/ / tw. news. yahoo. com/ % E5……5% 99% E8% 82% B2- 090406939. html;_ylt=AnbXu1A0PyeL2P5K.BxudHSUBdF_;_ylu=X3oDMTRlcTY3ZG5kBG1pdANUb3BzdG9yeUZQIEFydGljbGVTZWN0aW9uTGlzdARwa2cDYzQyZmQ1YzMtYmJkMC0zNDYxLWE2YjMtZGVkODIxYjBmNGY0BHBvcwM2BHNlYwNNZWRpYVNlY3Rpb25MaXN0BHZlcgM3NTRhNGI2OS1iYzU5LTExZTEtYWFmNy1mN2JhODIwYzdhNGQ-;_ylg=X3oDMTJvb2J1bnFtBGludGwDdHcEbGFuZwN6aC1oYW50LXR3BHBzdGFpZAM4NmIzZWY5Yy02MTVjLTNkOWUtYmNkNi03N2FmZDQzN2UzMGQEcHN0Y2F0AwRwdANzdG9yeXBhZ2U-;_ylv=3