Fri, Mar 26, 2010 - Page 8 News List

Rise in NHI premiums not enough

By Liu Ching-ming 劉競明

This fast-food approach to medical treatment may well be convenient and inclusive, but it makes it impossible for a doctor to take good care of a patient.

Consider also that consultants specialize in different fields, and sometimes may be unable to treat a patient straight away after finding that he or she needs to see a specialist in another field. This could mean that a patient may have to go from one department to another, seeing maybe three doctors in one day.

In this case, setting up special departments that feature a specific combination of specialties might be a good idea. This is one avenue that hospital administrators can explore to improve the quality of medical treatment provided after the health insurance increases come into effect.

People sometimes talk about how good US clinics are, but is there such a difference between how they do things over there and how things are done here? In the US, people first visit a general practitioner, who then refers them to a specialist. The treatment is therefore very private and tailored to the needs of the individual. Patients get a thorough check-up and the type of care that they need, and there are no limits on the time spent on the consultation (with initial consultations lasting at least 30 minutes), or restrictions on how many patients can be seen. The problem is that this does not come cheap.

As I see it, we are unlikely to see much improvement in the way things are done here, or in the quality of the healthcare provided under the current health insurance system, unless patients agree to pay the full costs of a preferential service or the international medical departments like the specialist outpatient clinics that China has. If we can have a system that combines a personal medical savings account system with personal health promotions and health management initiatives as a mechanism for paying health insurance, we might be able to keep the rising costs of public healthcare under control. I believe this is the way to tackle the root of the problem.

Liu Ching-ming is an attending physician and assistant professor in the Department of Obstetrics and Gynecology at Linkou Chang Gung Memorial Hospital.


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