In Taiwan, the Current Health Expenditure (CHE) accounts for 7.5% of GDP, which lags behind that of most OECD member states. The healthcare industry is urging the government to increase investment in health. Dr Twu Shiing-Jer, a former health minister, expressed that although the public in Taiwan rates the NHI services highly, the country lags behind Japan and South Korea in several areas, such as neonatal mortality rate and average life expectancy. To catch up with other countries, Dr Twu suggested that the government should increase NHI revenue, reduce expenditure, enforce the family doctor system, and implement the capitation payment system. He noted that it is disgraceful that hospitals constantly have to haggle over payment prices with the government.
The office of Legislator Wang Cheng-Hsu (DPP) and the Taiwan Society of Health Economics recently held a public hearing on "Achieving Healthcare Targets in Taiwan through Effective Health Investment." During the event, Dr Twu noted that 20 years ago, South Korea's average life expectancy was two years shorter than Taiwan's; however, by 2022, Taiwan had fallen two years behind South Korea. The gap spans nearly five years, which is a very serious issue. Despite the financial strain on the NHI, the government has been reluctant to increase premiums, opting instead for an alcohol levy. Dr Twu emphasized that it is not only the government's responsibility but also that of the public and the healthcare industry to collaborate in solving this problem. Otherwise, any NHI reforms will be futile.
The neonatal mortality rate in Taiwan has increased from 0.254% to 0.301%, while it has decreased by 60% in South Korea and 50% in Japan. This trend highlights the poor healthcare quality and insufficient health investment in Taiwan. "As neonatal mortality rises, the introduction of cancer drugs is delayed, and life expectancy declines, is keeping the NHI premium low really a good thing for the people?" asked Dr Twu.
Dr Twu emphasized that preventive medicine is the solution, as it reduces the demand for treatment and, consequently, lowers healthcare expenditure. He argued that the NHI should not only cover disease treatments but also actively promote health to genuinely conserve NHI resources. Dr Twu urged the MOHW to allocate 1% to 5% of the NHI budget for the establishment of a Preventive Medicine Promotion Committee. The committee's missions would include policy-making, promoting and supervising policy enforcement, and conducting cost-benefit studies.
He also advocates for the enforcement of Article 44 of the NHI Law, which stipulates the implementation of the family doctor system and the capitation payment system. Dr Twu explained that this approach would ensure that doctors benefit from keeping their patients healthy, providing them with an incentive to promote preventive medicine.
Mr Chang Yu-Bin of the NHIA conceded that Taiwan lags behind many countries in several healthcare quality indices. He emphasized that this is a serious issue that needs to be addressed. Mr Chang noted that the NHIA continues to promote the family doctor system, with a Family Doctor Care Network currently under construction. In the future, family doctors will serve as gatekeepers in the triage process. Regarding the capitation payment system, the NHIA plans to implement it initially for certain selected diseases and gradually expand its application.
【2024-08-14 / United Daily News】
