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
Japanese Prime Minister Fumio Kishida on Thursday last week met with Chinese President Xi Jinping (習近平) at an APEC summit in Thailand. The meeting made front-page news in Japan the following day. Three years ago, when then-Japanese prime minister Shinzo Abe visited Beijing to meet with Xi, no one questioned Abe’s attitude toward China, as the conservative parties in Japan had been spearheaded by Abe. However, Kishida could easily be labeled as pro-China, as he hails from Hiroshima — a place known for its anti-war, anti-nuclear movements — and was once the director of the Japan-China Friendship Association of Hiroshima.
It is quite the irony when former British prime minister Boris Johnson — a buffoon who for far too long was taken seriously — is branded a buffoon for saying something deadly serious. Following Johnson’s withering criticism of China at a business forum in Singapore on Wednesday last week, the event’s organizer, Michael Bloomberg, apologized to attendees, saying that Johnson was “trying to be amusing rather than informative and serious.” However, Johnson’s characterization of China as a “coercive autocracy” that had showed “a candid disregard for the rule of international law” was spot-on. His comments evoked the wisdom of the Austrian-British philosopher
Although internal Chinese politics are largely defined by meticulously concocted mysteries, it is an open secret that the battle for who will ascend to the highest echelons of Zhongnanhai is decided at the Beidaihe resort. It is where factions within the Chinese Communist Party (CCP) engage in horse-trading over leadership selection and delegate appointments long before the party’s national congress. What unfolded at last month’s 20th National Congress was predetermined at the Beidaihe gathering in August. In this context, the CCP, and particularly Chinese President and CCP General Secretary Xi Jinping (習近平), used the event to project power and party unity.
As campaign fever for tomorrow’s local elections turns white hot, supporters of the Democratic Progressive Party (DPP) and the Chinese Nationalist Party (KMT) have been going head to head on social media. The latest row was triggered by a Facebook post on Nov. 13 by songwriter and KMT supporter Liu Chia-chang (劉家昌), who rebuked United Microelectronics Corp founder Robert Tsao (曹興誠) for advocating independence. “Although you regained your ROC [Republic of China] citizenship after returning from Singapore, you continue to help the green independents by guarding their flank,” Liu wrote, adding that it was an “insult to the nation.” “When [KMT
RSS