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2025.10.17 [Health Channel \/ Comprehensive Report]<\/strong><\/p>\n Recent discussions surrounding overwork among healthcare professionals and the reform of Taiwan\u2019s National Health Insurance (NHI) system have intensified. Experts from various sectors have shared their experiences and international comparisons in search of feasible improvements. Former Director-General of the National Health Insurance Administration (NHIA) and Chair Professor at Taipei Medical University\u2019s College of Public Health, Lee Po-Chang<\/strong>, together with several co-authors, published an article titled \u201cSystemic strains and reform imperatives in Taiwan\u2019s health-care system\u201d<\/em> in the international journal The Lancet<\/strong>. The paper provides an in-depth analysis of the current challenges faced by Taiwan\u2019s healthcare sector and proposes several reform measures.<\/p>\n Fee-for-Service Payment Model:<\/strong> The Double-Edged Sword of Universal Health Coverage:<\/strong> Chronic Shortage of Healthcare Workforce:<\/strong> Stagnation in Systemic Reform:<\/strong> \u25cf Rebalancing Workload:<\/strong> \u25cf Aligning Incentives with Value-Based Care:<\/strong> \u25cf Rational Cost-Sharing:<\/strong> Finally, Lee Po-Chang emphasizes that only by embedding sustainability<\/strong> at the core of institutional design can Taiwan\u2019s National Health Insurance system maintain resilience and equity amid future challenges such as population aging, rising medical technology costs, and pandemics.<\/p>\n Original Source\uff1ahttps:\/\/health.ltn.com.tw\/article\/breakingnews\/5214267<\/p>\n <\/p>\n","protected":false},"excerpt":{"rendered":" 2025.10.17 [Health Channel \/ Comprehensive Report] Recent discussions surrounding overwork among healthcare professionals and the reform of Taiwan\u2019s National Health Insurance (NHI) system have intensified. Experts from various sectors have shared their experiences and international comparisons in search of feasible improvements. Former Director-General of the National Health Insurance Administration (NHIA) and Chair Professor at Taipei […]<\/p>\n","protected":false},"author":14,"featured_media":6775,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[91],"tags":[],"yoast_head":"\nLee Po-Chang identified the following major issues:<\/h3>\n
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The article points out that Taiwan\u2019s fee-for-service<\/em> model encourages service volume but inadvertently shifts the focus of medical institutions from \u201cquality\u201d to \u201cquantity.\u201d Physicians are often compelled to increase prescriptions and diagnostic tests to maintain income, leading to excessive consumption of medical resources. While this system supports high accessibility and low co-payment<\/em>, it also creates a vicious cycle of overutilization<\/em> and physician burnout<\/em>.<\/p>\n<\/li>\n
Taiwan\u2019s low out-of-pocket payment system allows easy access to healthcare, resulting in high consultation rates and a high physician-to-patient ratio. While this reflects the success of universal health coverage, it also places an enormous burden on the healthcare system. The public\u2019s \u201cmedical overuse\u201d further strains physicians, compromising both care quality and patient safety.<\/p>\n<\/li>\n
The authors highlight the shortage of healthcare personnel with data: Taiwan has only 2.39 physicians per 1,000 people<\/strong>, far below Japan (2.60), South Korea (2.51), and the OECD average (3.66). Nursing manpower is also insufficient\u20143.33 nurses per 1,000 people<\/strong> (compared with a required 8), while Japan and the OECD average 12.10 and 9.66 respectively.
More than one-third of physicians work over 60 hours per week<\/strong>, and over half of those participating in Pay-for-Performance (P4P)<\/em> programs do not actually receive bonuses; some even share losses. Long working hours and inequitable pay have triggered burnout and high turnover, further worsening the workforce gap.<\/p>\n<\/li>\n
The article stresses that NHI reforms in Taiwan have long focused on \u201cpayment adjustments\u201d or \u201cpoint value recalibration\u201d rather than structural changes. The current challenges extend beyond financial strain\u2014they threaten the sustainability of the system<\/em> and the resilience of medical professionalism<\/em>. Without redistributing workloads, realigning incentive structures, and establishing fair cost-sharing mechanisms, the long-term sustainability of NHI may be at risk.<\/p>\n<\/li>\n<\/ol>\nRegarding NHI reform, Lee Po-Chang proposes that efforts should \u201cgo beyond tweaking reimbursement formulas\u201d and focus on the following key directions:<\/h3>\n
Alleviate administrative burdens on clinical physicians through better division of labor and digital support systems; strengthen primary care and community health networks to reduce overconcentration in large hospitals.<\/p>\n
Shift from fee-for-service<\/em> to value-based care<\/em>; link performance rewards to care quality, patient satisfaction, and long-term health outcomes. Additionally, introduce non-monetary incentives that enhance job satisfaction and professional growth, such as educational support, career development, and mental health protection.<\/p>\n
Introduce modest increases in co-payments or implement a tiered cost-sharing system to discourage unnecessary visits. Promote public education on the finite nature of healthcare resources<\/em> to encourage responsible use of medical services.<\/p>\n