The government’s initiative to allow local hospitals to provide medical services to foreigners within the planned free economic pilot zones may hurt the rights of local patients and exacerbate poor working conditions for doctors under the National Health Insurance (NHI) system, an association dedicated to enhance work environments for doctors said yesterday.
The initiative was part of the proposed pilot zones project, which is under review in the legislature’s economics committee.
If the pilot zones draft is approved, local hospitals are to be allowed to apply to set up a division that is not under the current healthcare system, the Ministry of Health and Welfare said in a report delivered at a public hearing in Taipei yesterday.
The ministry will set a maximum time for every local doctor to work in the divisions to avoid reducing medical resources in the healthcare system, the report said.
Local hospitals will have permission to hire foreign doctors when necessary, the report said.
If hospitals can generate profit from the divisions, they have to share part of the profit with the healthcare system, it said.
However, Doctors’ Working Conditions Reform Task Force (醫師勞動條件改革小組) executive commissioner Chen Liang-fu (陳亮甫) told the hearing that he was skeptical about the initiative.
The government is unable to monitor the working time of doctors, which will make the regulations on maximum working time in the newly established divisions ineffective, Chen said.
As a consequence, to generate more income, doctors are likely to spend more time providing services to foreigners, while reducing the time they spend on patients who are covered by the healthcare system, he said.
The ministry is also incapable of auditing the financial conditions of hospitals, so there is no guarantee that a hospital will share its profit earned in the new divisions with the healthcare system, he said.
“Furthermore, we do not see any penalty in the draft for hospitals violating these requirements,” he said.
Chen said many medical students in Taiwan have already opted for more lucrative specialties, such as plastic surgery, which has reduced the proportion of doctors able to practice internal medicine, surgery, gynecology, pediatrics and emergency medicine.
The pilot zone policy will exacerbate that trend, he added.
As doctors who work under the healthcare system already face long hours, when some highly reputed doctors spend more time in the new divisions, the workload for other doctors will necessarily increase, Chen said.
However, Kaohsiung Medical University professor Jeng Cherng-jye (鄭丞傑) said the national healthcare system offers substandard income for doctors, which causes a lot of Taiwanese doctors to practice abroad.
The pilot zone policy offers incentives for world-renowned doctors to stay in Taiwan, Jeng said.