The NHI has been facing various problems in recent years. After the pandemic, those problems have gradually emerged onto the surface, such as the shortage of nursing and medical manpower and the inaccessibility of new drugs. Experts pointed out that the NHI's low-price policy has led to multiple healthcare crises. They urged the government to increase health investment and build a robust healthcare system so that the health index in Taiwan can meet international standards.
The MOHW Minister, Dr Hsueh Jui-Yuan, and the NHIA Director-General, Dr Shih Chung-Liang, both delivered speeches at the 2023 annual conference of the Taiwan College of Healthcare Executive (TCHE). The theme of this year’s conference focused on “Health Investment and Sustainability", echoing their “2023 Taipei Healthcare Declaration” made in February. The declaration emphasized that health spending is an investment that enhances the quality of life, happiness and prosperity.
Dr Hung Tze-Jen, President of TCHE, highlighted the relationship between medical input and health output. Taiwan currently ranks 37th on the global health index chart, with the current health expenditure (CHE) accounting for only 6% of GDP. Dr Hung urged the government to increase this ratio to 8% by 2028 to meet international standards.
Dr Hung also called on the public, the industry, and the government to support the NHI for the purpose of improving healthcare quality. He mentioned that the WHO has twice urged all governments to increase their investment in health and build robust healthcare systems to better prepare for the next pandemic. Therefore, all stakeholders need to reach a consensus to ensure that the NHI's global budget and its growth rate are sufficient to secure a better future.
Dr Chang Hong-Jen, a former NHIA Director-General, pointed out 3 major myths about the healthcare system in Taiwan. The first myth is that "health expenses can be controlled by a global budget". The second myth is that "prevention is better than treatment and can save money". The last myth is that "control is better than market mechanism." There is a fallacy about the global budget, assuming that healthcare demand is fixed, and the budget only needs adjustments based on price level and age structure. As a result of this hypothesis, the budget for new drugs and new technologies has remained insufficient over the past 20 years.
Dr Chang claimed that the NHI's best days are behind it. The original spirit of the NHI was to provide care for the people, but now it seems to be primarily focused on financial considerations. Taiwan's health index lags far behind those of Singapore, Japan, and South Korea. The NHI's low-price policy has contributed to multiple crises, with the public often misusing resources on the treatment of ailments, duplicate prescriptions, repeated tests, among other issues. Meanwhile, hospitals are grappling with deficits and a shortage of manpower.
Dr Chang pointed out that many people support the idea of "user fees," which involve charging a co-payment to control waste. However, he emphasized that this method has limited impact and should be used carefully. Instead, he suggested either abolishing the global budget or providing a guaranteed point-value at NT$0.9. Once again, he expected the government to turn the situation around by increasing health investment, expanding domestic demand, and relaxing regulations.
【2023-10-22 / China Times】
