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Reform healthcare to heal society

According to media reports, people are lining up to condemn Chao Chien-ming (趙建銘), a physician and President Chen Shui-bian's (陳水扁) son-in-law, for his alleged involvement in an insider trading scandal. Based on the proverb, "Men at birth are naturally good" (人之初,性本善), people may wonder why Chao, who was an intelligent and outstanding student, has now become suspect number 2260. If Chao is convicted, then Taiwanese society will have to reflect on the question of what went wrong with Chao's family, his school and with social education in general.

Not so long ago, Chao was indicted in a medical malpractice lawsuit for negligence when treating an old woman. I do not know the amount of compensation that was asked for in the case, nor the case's subsequent development. But Chao, a physician at a public hospital, whose monthly income is no more than NT$100,000 or so, surely could not afford to pay such a large amount in compensation.

Could this lawsuit have changed Chao's view of life so much that he began accumulating wealth? In the US, it is far from uncommon to read reports about physicians who act irrationally and later commit suicide after becoming embroiled in medical malpractice lawsuits.

Medical malpractice can be discussed from four aspects: a physician's knowledge, their service attitude, the healthcare environment and the healthcare system.

Being trained in clinical medicine at the College of Medicine at National Taiwan University (NTU) and a resident physician at National Taiwan University Hospital (NTUH) from 1959 to 1966 as well as a professor in the College of Medicine at NTU and NTUH since the 1970s, I have witnessed the overall deterioration in clinical training and healthcare quality.

Back when Chao served in the Department of Health's Taipei Hospital, neither organization nor service quality could measure up to that of NTUH, and so it was therefore understandable that family members were upset after their relative died.

The past 50 years have seen the implementation of the labor, civil service and national health insurance systems. Physicians active throughout this period have seen how low premiums and insufficient healthcare payments have led to inferior medical education, a failure to monitor and guide the performance of resident physicians and staff shortages at many hospitals, so that patients do not get the hospital care they deserve. In other words, our nation's health insurance system is the main culprit behind today's deteriorating healthcare standards.

After the humiliated first family's halo lost its luster, everybody should have sympathized with them rather than gloating over their misfortune. I hope that Chen will immediately move to reform Taiwan's healthcare system based on the report on the state of national health insurance and reform compiled by Sung Jui-lou (宋瑞樓) and Huang Ta-fu (黃達夫) for former minister of health Lee Ming-liang (李明亮).

If Chen can successfully improve the quality of Taiwan's healthcare system and bring happiness to the general public, we will still respect him as a great president.

Hsieh Yen-yau is a retired professor from the College of Medicine at National Taiwan University.

Translated by Lin Ya-ti
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