Taiwan’s public policy and think tanks jointly organized a seminar today (16th) to discuss the topic: “Health Insurance Financial Alarms: Points, Medication Costs, Personnel – Who Will Win?” Scholars and experts were invited to analyze the situation.
Opening the seminar, Zhang Zhuqin, Director of the CET Academic Programs Taiwan Center, noted that Taiwan’s health insurance has been in place for thirty years and is facing challenges from demographic changes and shifts in healthcare services. Different generations hold varying perspectives on health insurance, necessitating thorough discussions to make appropriate adjustments.
Director of the Taiwan Think Tank’s Polling and Public Sentiment Center, Guo Meicen, brought up the recent fervent discussions sparked by the Kuomintang’s proposed amendment to the “Elderly Welfare Law.” Supporters view it as a concrete implementation of constitutionally safeguarded health rights, while opponents express concerns that the amendment may worsen health insurance finances, exacerbate intergenerational resource distribution inequalities, and impact the system’s sustainability.
Guo Meicen presented several statistics, citing Taiwan’s top ranking in the Global Healthcare Index and a high public satisfaction rate of 91.2%. However, frontline healthcare workers only exhibit a 33% satisfaction rate with the health insurance system, starkly contrasting with the general public’s satisfaction. She highlighted the current situation leading to a severe wave of departures among nursing staff and emergency department doctors, resulting in staff shortages, ward closures, surgery delays, and emergency room congestion.
In the face of these challenges, she emphasized the need for diverse and rational dialogues to drive reforms amidst the tide of societal change, hoping that discussions will raise awareness and encourage more people to safeguard the future of universal health insurance – a precious social asset in Taiwan.
Associate Professor at National Taiwan University’s Institute of Health Policy and Management, Kuo Nianzhen, stressed that health insurance is one of Taiwan’s most critical social security systems since democratization. It effectively provides financial assistance to all citizens, reducing their medical burdens and risks. During the last presidential election, all candidates pledged to increase national health expenditures from 6% to 8% of GDP, showing a bipartisan consensus on investing more in healthcare.
Kuo Nianzhen raised the question of how to allocate these funds effectively – whether towards advanced treatments for severe diseases, new drugs, improving working conditions and compensation for healthcare personnel, among other contested areas. He acknowledged the complexity of the issues and urged more individuals, particularly the younger generation, to focus on the future of universal health insurance and seek consensus.
Secretary General of the Taiwan Research and Development Pharmaceutical Association, Chen Quanwen, emphasized that everyone desires longevity and good health, making investments in healthcare essential. He suggested that medical resources should expand based on need rather than seeking minimal investments. While drug expenses typically account for about 20% of total healthcare costs worldwide, Taiwan’s rate stands at 29%. Chen elaborated that this disparity might not stem from pharmaceutical companies seeking excessive profits, but rather low overall healthcare expenses causing medications to form a higher proportion. Reasonable drug prices can expedite the introduction of new drugs and therapies in Taiwan, while fair compensation for healthcare professionals can prevent a mass exodus and ensure quality care, necessitating increased investments.
Analyzing the situation, Chen Botong, Executive Director of the Legislative Yuan’s Health and Welfare Committee, pointed out that Taiwan excels in healthcare accessibility, making medical care easily accessible to the population. However, overall performance – including average life expectancy and cancer survival rates – lags behind countries like South Korea, indicating substantial room for improvement in Taiwan’s healthcare system. He highlighted issues of “fairness and justice” in the universal health insurance system, illustrating urban-rural disparities like Taipei having one doctor for every 200 people compared to some remote areas where thousands share one physician. A stagnation in healthcare personnel salaries for years, compounded by deteriorating work environments post-pandemic, has left frontline workers feeling powerless and unfairly treated.
President of the Taiwan Professors’ Association, Chen Lipu, emphasized that healthcare is a human right and a symbol of societal progress, underscoring the need to not passively follow trends in the medical environment. Demanding better healthcare, improved medication, while opposing premium hikes is unrealistic wishful thinking. He urged a serious contemplation on reshaping Taiwan’s healthcare into social health welfare, user-pay systems, maintaining social insurance, or transitioning to commercial insurance schemes, assessing the necessary sacrifices and engaging in thorough discussions and implementations. Especially for the youth, who will have more opportunities to utilize health insurance in the future, they should invest time and effort in shaping their ideal healthcare environment.
Following the discussions, the host and young participants raised questions regarding “healthcare accessibility,” “medical waste,” “aging’s impact on healthcare and responses,” and “equity and financial fairness of health insurance.” The speakers engaged in detailed analyses and responses to each query.