When healthcare officials talk about the National Health Insurance at home or abroad, they boast that there is almost universal coverage, and that the system is not only "cheap and abundant" but also "incomparably convenient" -- anyone can see a doctor anywhere without needing to wait.
Yet, in his lecture "Creating a high-value healthcare system: Implications for Taiwan" on April 30, management guru Michael Porter said that while Taiwan's universal health insurance is an extraordinary achievement, insurance is only one segment of healthcare policy. The ultimate goal of the national health insurance policy is "protecting the health of all the people," and its most important task is to provide "high-value healthcare" for all.
Value-based healthcare means it is best to prevent illness, or to detect illness at an early stage, quickly come to the correct diagnosis, give the right treatment at the appropriate time and avoid mistakes in the course of the treatment.
What people should expect from health insurance is proper protection of their health; they should not be looking to receive more medicine, more health checks, or more treatment. Merely giving people a lot of medical services, said Porter, does not benefit them at all.
Porter proposed a direction for the future. Apart from those hospitals that provide basic healthcare, different hospitals should specialize in the treatment of different major diseases. Also, quality should be determined by universalization, implying that no matter how many hospitals there are, they are of no use if they do not provide quality care.
When people in the audience suggested that without universalization, convenience is lost, Porter gave this example: There are 139 hospitals that conduct heart transplants in the US. Some are good hospitals that have a lot of experience and a fatality rate in surgery of zero, and some are bad ones that only do a few operations a year, don't have much experience and have a fatality rate of 100 percent. In the end, it would be enough if there were only 20 or so hospitals left that offer this surgery.
Of course, no one would choose a hospital that has a 100 percent fatality rate just because it is more convenient to get a transplant there. Therefore, when making decisions about life and death, convenience is the lowest priority.
So why is it that the public is content with a healthcare insurance that boasts of being "cheap and abundant" and convenient, causing hospitals to use their size and equipment as an appeal?
The problem is that the public lacks a standard with which to judge the quality of healthcare, so they believe "if the temple is big, there must be a god in it." "Cheap and abundant" healthcare means hospitals can earn more, and convenience means good service.
Porter is of the opinion that no matter how cheap, bad healthcare is a waste. The most effective way to control medical expenses is by increasing the quality of healthcare, that's why the competition in healthcare will be competition in quality.
Therefore, one of the main points of insurance reform is to establish a system for surveying the quality of care by setting up an information network. After that, the results have to be more transparent. A good health insurance system should also encourage the constant improvement and innovation in the healthcare system so that hospitals who improve get more resources.
The most important thing is to give the public a basis to judge for themselves how good or bad a hospital is, giving them the opportunity to have more control over their own lives.
Andrew Huang is the president of the Koo Foundation Sun Yat-sen Cancer Center.
Translated by Anna Stiggelbout
The global chip shortage last year caused an unprecedented supply-chain crisis, affecting many key industries, including the auto industry. Europe, Japan and the US began to realize the indispensability and ubiquitous dominance of Taiwan’s semiconductor manufacturing industry. At the same time, amid the US-China trade war, Beijing’s military aggressions against Taiwan became increasingly blatant and provocative. In light of these developments, Europe, Japan and the US are formulating new policies to rebuild their domestic semiconductor manufacturing base, so as to mitigate the enormous geopolitical and economic risks involved. Last year, Taiwan Semiconductor Manufacturing Co (TSMC) commanded 56 percent of the global
When I was teaching in Lesotho in southern Africa during the 1980s, I taught a class on comparative foreign policy. The course included trips to the US embassy, the Soviet embassy, the British embassy and the newly established Chinese embassy. The students could ask the ambassadors and staff questions about foreign policy, and would then write a report as their final term paper. The Chinese ambassador felt that the US-style education I delivered was unique and invited me to go to China to teach. At the time, China was planning to open up to the world, and it needed professors versed
Taiwan Taoyuan International Airport on June 15 relaxed COVID-19 restrictions on passengers transfering to connecting flights. In a Taipei Times article titled “Best move to re-establish passenger transits first” (June 7, page 8), I said that before Taiwan reopens its borders, the government should allow the nation’s international airports to resume transit passenger operations so that their operators and airlines have enough time to review staffing and equipment needs. This would enable Taiwan’s airports to avoid following in the footsteps of airports overseas, which have been inundated with long flight delays due to staff and equipment shortages. One example that
As the geopolitical effects of Russia’s invasion of Ukraine become more obvious, the collective defense provided by NATO is the key security umbrella that unites European countries and protects them from further intrusion by their malicious eastern neighbor. With Finland and Sweden having been invited to join NATO — which, if they join, would increase the number of member states from 30 to 32 — two more nations in the region are in line to be included in the regional security pact. Meanwhile, the support that Russia has been receiving behind the scenes from China and other countries is one of the
RSS