Written by Tsung-Mei Cheng. Chronic financial instability and the difficulty the government has with raising the premium rate to balance the budget aside, the NHI faces myriad other challenges, including rising patient-consumer expectations and demands for ever more and better health care, the high cost of new medical technology and its coverage, provider payment reform, health care workforce shortages, ageing of the population, building long term care, etc.
Written by Po-Han Lee. The ethical imperative of the human rights-based approach to public health requires the ‘acceptability’ (including cultural appropriateness) of health policymaking, impact assessment, and care services. In this context, Cultural competence in public health practices is concerned with ‘health for all’ through ‘safety for all’. That is, the principle of cultural safety, along with awareness of intersectional marginalisation, is to eliminate health inequities due to systemic racism and eventually decolonise public and global health practices.
Written by Chunhuei Chi. Beyond the pandemic, our healthcare system will face more future challenges, from chronic diseases of the ageing population and emerging new infectious diseases to the health impacts of climate change. We need a strengthened healthcare system that is innovative, adaptable, trusted, and governed by the people to face these challenges.
Written by Wei-hong Chen. According to the 2019 survey from the World Confederation of Physical Therapy, in 79% of its member countries, (as Australia and Canada, and the UK,) PTs can provide services without supervision from a doctor. Taiwan falls into the minority of countries in which PTs can only operate under a Doctor’s orders. This restricted referral model is enforced in legal and medical systems, and as a result, the quality of physical therapy in Taiwan has been seriously hindered.
Written By Tsung-Mei Cheng. As recent as the end of 2019, Taiwan’s public gave the NHI a 90% satisfaction rating. The questions at hand are: how will Taiwan’s public and their representatives in parliament respond to the urgent need to balance NHI’s budget in the near-immediate term? Moreover, how will they help build a health system of greater efficiency and quality in the longer term by agreeing to pay more for the health care they have come to expect?
Written by Elsa Sichrovsky. A mixed-reality approach to anatomy courses may be an ideal approach to combining the efficiency of VR technology–and its enhancement of the acquisition of knowledge–with the psychological enrichment and tactile experience of learning from the Silent Teacher. A former medical student brought up an intriguing idea on an online discussion forum: perhaps students could practice anatomy with VR technology before dissecting the Silent Teacher. By doing this, students would approach cadaver dissection already possessing a higher level of anatomical knowledge, and thus fewer unnecessary cuts would be made.
Written by Hsu Hung Bin.The history of doctor outflow in Taiwan tells us that doctors of all eras are continually reflecting on what it means to be in the medical profession and what the “good life” of a doctor is. The unique history of Taiwan’s medical system is an essential resource as we come to reflect on the issues of today. This history reminds about the diverse sets of values (not all of which have been good) that have existed within the system. It also provides clues of what a new system might look like.
Written by Hsu Hung Bin. The phrase “五大皆空” (all the key fields are lacking) has become common, referring to the lack of doctors in internal medicine, surgery, gynaecology, paediatrics and emergency care. There has also been discussion of the net outflow of doctors from Taiwan. All of this brought doubts to the once hopeful students as they began their medical education. I often hear students asking questions like “is the medical system here really going to collapse?” “Do we have to leave Taiwan and start a new life abroad?” “Did I make the right choice for my career”?
Taiwan Insight 