It was widely reported that Taiwan retained the top ranking for the seventh consecutive year on Numbeo’s Health Care Index. Taiwan scored 86.5 on a scale of zero to 100 on the regular index and 159.2 on the exponential index, which places greater emphasis on positive responses to its surveys.
However, do the rankings reflect what truly happens in Taiwan’s medical system?
What I see on the front lines working at a medical center is a much starker reality. For many years, Taiwan’s medical industry has been rooted in the National Health Insurance (NHI) system, which provides high-quality services at low cost by exploiting healthcare workers, who work themselves into the ground.
While they are proud of the No. 1 rankings, the government and the media turn a blind eye to the predicament faced by healthcare workers. They even use it as an excuse to rationalize not increasing NHI premiums and refusing to improve the work environment, which could lead to the collapse of the healthcare industry.
The Numbeo rankings are based on how respondents feel about healthcare workers’ attitudes, convenience of access to medical services and cost. It is not a professional evaluation of the quality of medical services.
Taiwan’s high satisfaction rate comes on the back of medical professionals working overtime, and dealing with low incomes and fatigue. Healthcare workers are enslaved to fill a resource gap, sacrificing their mental and physical health while earning less than they should.
NHI premiums have not gone up for years. To survive, hospitals and clinics have to lower their costs and it is healthcare workers who face the consequences. Long working hours, high-risk work and low income are factors contributing to the trend of young physicians being unwilling to specialize in areas such as emergency medicine, surgery, obstetrics and gynecology to avoid high-pressure work environments. Even fields that are said to be relatively less stressful, such as ophthalmology and dermatology, are not appealing enough to retain talent.
The shortage of personnel worsens every day. Primary care providers are under pressure to deal with an increasing patient load, while the NHI system requires healthcare workers to do administrative work that is unrelated to medical care itself with no increase in resources.
The government should address and recognize the predicament and stop taking credit for rankings from opinion-based surveys. It must stop finding excuses to shrug off its responsibilities to implement healthcare reform.
Improving healthcare services should not require endless sacrifices by healthcare workers. For the sake of public health, problems in the industry should be addressed so that the Numbeo ranking is not merely superficial glory, but truly represents the well-being of healthcare workers and patients.
Lu Chun-wei is a dermatologist and Chang Gung Memorial Hospital assistant.
Translated by Fion Khan
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