The imbalance in the distribution of medical resources between urban and rural areas is worsening, prompting much criticism. Large hospitals frequently defend the situation as a normal state of affairs in a market economy. The public vote with their feet, they say, and the government should not interfere.
It is indeed a matter of market economics when large hospitals use their massive purchasing power to press medical suppliers to make drastic price cuts. It's also a matter of market economy when large hospitals tell doctors during salary negotiations that their wages are only about half that of their colleagues at regional hospitals outside urban areas because living conditions in urban areas are much better.
Large hospitals demand higher payments for their services by stressing their original mission of treating serious illnesses. But then they make every effort to attract people with minor illness, expanding their outpatient services in order to boost business.
This exercise in "hanging up a sheep's head but selling dog meat" (
The massive marketing efforts involved in attracting patients are an abuse of the hard-pressed National Health Insurance (NHI) program, which is a public asset. Unfortunately, both the Department of Health (DOH) and the Bureau of National Health Insurance (BNHI) are just sitting back and watching the problems develop.
It is particularly bewildering that large hospitals never talk about the principles of market economics when billing the bureau for health insurance payments. They purchase large amounts of medical supplies at low prices, in the manner of hypermarkets. Why don't they charge the bureau wholesale prices, instead of charging the same prices as regional hospitals and saying that it's the "standard medicine price."
Their various services are much more expensive than in regional hospitals -- disparities in cost and range of provision notwithstanding. What kind of market economy is this?
In fact, it's a thoroughly unfair market that guarantees the dominance of the large hospitals.
Obviously, the national health program is a "half-baked" market economy. Not only have the DOH and the bureau long ignored this unreasonable sate of affairs, but they have also frequently echoed the large hospitals' claims. They have even demanded that the regional hospitals strive to improve their quality.
All this fosters the impression in the regional hospitals that both the DOH and the BNHI are run by the large hospitals.
In this kind of healthcare market, it is too easy for large hospitals to push aside any hurdles to their prosperity, a fact which lends undue credit to health authorities.
If the situation continues, regional medical institutions will gradually shrink in size and then disappear. Convenient medical treatment and emergency care in rural areas will fall by the wayside. The wider costs to society generally will increase substantially as people start to have to make long and difficult journeys to get treatment.
It would be a tragedy if we were to make that became the reality in Taiwan's rural areas.
It is particularly worrying that the quality of care for patients with serious illnesses could decline significantly if large hospitals do not attend to their proper duties while feverishly soliciting patients with minor illnesses.
If that happen, the people themselves will be the biggest losers.
Hsieh Wen-hui is a board member of the Taiwan Community Hospital Association.
TRANSLATED BY EDDY CHANG
Recently, China launched another diplomatic offensive against Taiwan, improperly linking its “one China principle” with UN General Assembly Resolution 2758 to constrain Taiwan’s diplomatic space. After Taiwan’s presidential election on Jan. 13, China persuaded Nauru to sever diplomatic ties with Taiwan. Nauru cited Resolution 2758 in its declaration of the diplomatic break. Subsequently, during the WHO Executive Board meeting that month, Beijing rallied countries including Venezuela, Zimbabwe, Belarus, Egypt, Nicaragua, Sri Lanka, Laos, Russia, Syria and Pakistan to reiterate the “one China principle” in their statements, and assert that “Resolution 2758 has settled the status of Taiwan” to hinder Taiwan’s
The past few months have seen tremendous strides in India’s journey to develop a vibrant semiconductor and electronics ecosystem. The nation’s established prowess in information technology (IT) has earned it much-needed revenue and prestige across the globe. Now, through the convergence of engineering talent, supportive government policies, an expanding market and technologically adaptive entrepreneurship, India is striving to become part of global electronics and semiconductor supply chains. Indian Prime Minister Narendra Modi’s Vision of “Make in India” and “Design in India” has been the guiding force behind the government’s incentive schemes that span skilling, design, fabrication, assembly, testing and packaging, and
Singaporean Prime Minister Lee Hsien Loong’s (李顯龍) decision to step down after 19 years and hand power to his deputy, Lawrence Wong (黃循財), on May 15 was expected — though, perhaps, not so soon. Most political analysts had been eyeing an end-of-year handover, to ensure more time for Wong to study and shadow the role, ahead of general elections that must be called by November next year. Wong — who is currently both deputy prime minister and minister of finance — would need a combination of fresh ideas, wisdom and experience as he writes the nation’s next chapter. The world that
As former president Ma Ying-jeou (馬英九) wrapped up his visit to the People’s Republic of China, he received his share of attention. Certainly, the trip must be seen within the full context of Ma’s life, that is, his eight-year presidency, the Sunflower movement and his failed Economic Cooperation Framework Agreement, as well as his eight years as Taipei mayor with its posturing, accusations of money laundering, and ups and downs. Through all that, basic questions stand out: “What drives Ma? What is his end game?” Having observed and commented on Ma for decades, it is all ironically reminiscent of former US president Harry