Taipei Times: As the nation's highest health authority, what are your major goals and your vision? And how do you plan to achieve them?
Hou Sheng-mou (
TT: In regards to promoting health for everyone, you have proposed a "dynamic fine-tuning" of insurance rates in multiple areas to bolster the NHI and ensure people's access to medical care. You said "dynamic fine-tuning" could pull in about NT$30 billion and ease the NHI's current financial difficulties. Yet some critics say that this is just a cosmetic solution. What is your response to this criticism?
Hou: I don't think insurance rates should be kept pegged at the same rate in a changing society, especially one with an aging population and ever-advancing medical technology. But dramatic and revolutionary change will not be accepted by our society without causing a lot of harm. People don't really want a revolution. So the subtleties lie in how to avert public uproar on a fare hike, and yet sustain the hemorrhaging NHI at the same time. I am a surgeon and a pragmatist. I will try to solve the problem by fine-tuning the NHI for now.
Indeed, the fine-tuning of several different insurance rates is not perfect, but at least it will bring temporary relief to the NHI's financial pressure. To root out all these problems at the NHI, however, we need a revolutionary, fundamental change.
* Date of birth: July 1, 1950.
* Place of birth: Chiayi County.
* Education: Master of Public Health at Johns Hopkins University, 1994-1998; PhD from the Graduate School of Clinical Medicine at National Taiwan University, 1985-1988.
* Career: Director of the school of medicine at National Taiwan University, 1995-2004; chairman of the Department of Orthopedic Surgery at National Taiwan University Hospital, 2000-2004; vice superintendent of National Taiwan University Hospital, 1995-2000.
TT: What do you mean by a "revolutionary" change to the NHI?
Hou: In the 21st century, you need innovative thinking and new ideas. To reform the NHI, we [health officials] have mapped out a "second generation NHI," which will carry completely different concepts from the old NHI.
For instance, in the second generation NHI, health insurance will be levied on the basis of household income, not just an individual's monthly pay. And we also plan to introduce the concept of accountability in the NHI system. By "accountability," I mean that the insured -- not just the government -- is held accountable. You pay for what you get. As you know, the insurance rate has only been raised once in the past decade, from 4.25 percent to a slightly higher 4.55.
On the other hand, however, Taiwanese people do not want to give up what they have now. No one wants to have narrower insurance coverage or higher premiums. Now, it is proven that the premiums we collect are not enough to cover costs. A fundamental change must be made in the way we collect premiums in the second-generation NHI. People in Taiwan must understand that the NHI is a rare blessing for all. When former US president Bill Clinton came to visit Taiwan, I tried to put him and former minister of health Lee Ming-liang (李明亮) together to discuss the merits of the NHI. To promote public awareness of the NHI's benefits, I even proposed donating half of my personal fortune to Clinton if he would say that the NHI is a blessing for Taiwanese people. It is widely known that the NHI offers easier access to medical care at a cheaper premium than the US' healthcare system.