Tue, Mar 29, 2016 - Page 8 News List

Healthcare reform must prioritize education

By Liu Mei-chun and Ku Chih-fen 劉梅君﹐辜智芬

According to media reports, Taiwanese last year spent NT$2 billion (US$61.1 million) on medication to treat colds and consumed 68.34 million pills, 46 tonnes of powdered medication and 300,000 liters of liquid medication.

To avoid the misuse of national health insurance resources, the National Health Insurance (NHI) Administration and the medical sector should advocate correct health education and promote the concept of self-care rather than tell people that they should go see a doctor if they suffer cold symptoms.

The main direction for healthcare policies in most nations has always been that prevention is better than cure, that people can treat minor symptoms themselves and that national health insurance resources should not be spent on self-healing disorders.


The health services in most nations, such as the UK’s National Health Service, provide health education through government or family physicians, so that people can learn how to treat colds by themselves and when they should see a doctor.

What the public really needs are doctors that are careful and meticulous in their health education.

That is why the medical sector and the government should provide adequate health education, such as teaching people how to assess a cold, which colds can be treated by drinking more water and resting, which should be observed and which require a visit to the doctor.


Administration statistics show that, on average, Taiwanese visit doctors more than 20 times per year, that NT$21.5 billion of NHI resources are spent on acute upper respiratory tract infections every year and that the percentage of visits to clinics that result in drug prescriptions is much higher than in advanced nations.

In addition, 14.5 of every 100 patients that visit a health center do so for light ailments, such as a cold, that could be treated using self-care measures.

That people purchase prescription-free cold medication also highlights several problems.

First, it shows that current registration fees for a visit to a doctor are too high and that it is much cheaper to buy cold medication over the counter. Doing so also avoids having to wait and is therefore seen as more cost-effective.


Second, although prescription-free drugs might be effective, and faster to obtain, there is a risk of people purchasing drugs that pose a health risk to them.

That is why improving self-care education is a key element of healthcare reform.

The Taiwan Healthcare Reform Foundation recommends a prompt implementation of Article 44 of the National Health Insurance Act (全民健康保險法) — which states that “the benefits of the family physicians system should be paid out on a per person basis” — and the establishment of a health education and consultation team that can win the public’s trust.

It also recommends the addition of warning labels to the outer packaging of drugs and user instructions to be placed inside the packaging that meet international standards.

This would improve the safety of self-care and a mechanism that ensures safe drug use, while also raising public health knowledge and awareness, and saving NHI resources.

Liu Mei-chun is a board member of the Taiwan Healthcare Reform Foundation. Ku Chih-fen is a researcher at the foundation.

Translated by Perry Svensson

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