{"id":7095,"date":"2026-04-27T11:03:07","date_gmt":"2026-04-27T03:03:07","guid":{"rendered":"https:\/\/tmuhprc.tmu.edu.tw\/?p=7095"},"modified":"2026-04-27T11:09:12","modified_gmt":"2026-04-27T03:09:12","slug":"unnecessary-medical-care-that-gets-paid-for-the-invisible-drain-on-healthcare-an-analysis-of-how-the-global-budget-of-national-health-insurance-leaks-into-the-explosion-of-indemnity-commercial-heal","status":"publish","type":"post","link":"https:\/\/tmuhprc.tmu.edu.tw\/en\/unnecessary-medical-care-that-gets-paid-for-the-invisible-drain-on-healthcare-an-analysis-of-how-the-global-budget-of-national-health-insurance-leaks-into-the-explosion-of-indemnity-commercial-heal\/","title":{"rendered":"\u3010New Book Promotion\u3011Unnecessary Medical Care That Gets Paid For: The Invisible Drain on Healthcare!! An Analysis of How the Global Budget of National Health Insurance Leaks into the Explosion of Indemnity Commercial Health Insurance Claims By Director Po-Chang Lee (Published on April 24, 2026)"},"content":{"rendered":"

\"\"<\/p>\n

\n

Unnecessary Medical Care That Gets Paid For: The Invisible Drain on Healthcare!!
An Analysis of How the Global Budget of National Health Insurance Leaks into the Explosion of Indemnity Commercial Health Insurance Claims<\/strong>
Po-Chang Lee<\/strong>
(Published on April 24, 2026<\/strong>)
Book purchase information: https:\/\/sharing.com.tw\/product\/index\/5ND08<\/a><\/h2>\n<\/div>\n
\n
\n

Book Features<\/strong><\/span><\/h2>\n

This is not merely a book about the finances of Taiwan\u2019s National Health Insurance (NHI). It is a book that reexamines what kinds of medical care Taiwan is actually paying for. Drawing from the intersection of clinical medicine, NHI governance, and insurance systems, the author argues that the core challenge facing today\u2019s NHI is not simply insufficient funding, but misaligned payment priorities.<\/p>\n

When the system continues to reimburse low-value medical services with limited marginal benefit, unnecessary care is repeatedly reproduced within a legal framework. In the end, this erodes point values, increases insurance premiums, exhausts healthcare manpower, and spills over into a loss-ratio crisis for commercial insurance.<\/p>\n

The book\u2019s greatest contribution lies in being the first to analyze NHI, self-paid healthcare, and commercial insurance within a single payment ecosystem. It shifts the discussion of unnecessary care away from moral blame toward institutional incentives, while proposing reform pathways involving co-payments, medical device governance, legal accountability, and smart governance.<\/p>\n

This is not only a book criticizing current problems\u2014it is a book calling for a recalibration of payment values and a rebuilding of institutional integrity.<\/p>\n

\n

About the Author<\/strong><\/span><\/h2>\n

Po-Chang Lee<\/strong><\/span><\/h3>\n

Current Positions<\/h3>\n
    \n
  • Chair Professor, College of Public Health, Taipei Medical University<\/li>\n
  • Professor of Surgery, National Cheng Kung University College of Medicine<\/li>\n
  • Director, Center for Health and Welfare Policy Research, Taipei Medical University<\/li>\n
  • Consulting Physician, Shuang Ho Hospital, Taipei Medical University<\/li>\n<\/ul>\n

    Education<\/h3>\n
      \n
    • M.D., Taipei Medical College<\/li>\n
    • Research Fellow in Surgery, University of California, Los Angeles (UCLA)<\/li>\n
    • Research Fellow in Transplant Surgery, Kyoto Prefectural University of Medicine, Japan<\/li>\n
    • Master\u2019s Degree, Graduate Institute of Technology Law, National Cheng Kung University<\/li>\n<\/ul>\n

      Previous Positions<\/h3>\n
        \n
      • President, Taiwan Society for Organ Donation and Transplantation Development<\/li>\n
      • Director-General, National Health Insurance Administration, Ministry of Health and Welfare (2016\u20132023)<\/li>\n
      • Chairman, Organ Donation and Transplantation Registry Center<\/li>\n
      • Superintendent, Tainan Hospital, Ministry of Health and Welfare<\/li>\n
      • President, Taiwan Society of Transplantation<\/li>\n
      • Professor of Surgery, National Cheng Kung University<\/li>\n<\/ul>\n

        Main Research Areas<\/h3>\n
          \n
        • Kidney transplantation<\/li>\n
        • General surgery<\/li>\n
        • Organ donation promotion and advocacy<\/li>\n
        • National Health Insurance policy planning, implementation, and management<\/li>\n<\/ul>\n

          Honors and Awards<\/h3>\n
            \n
          • Special Contribution Award for Organ Donation<\/li>\n
          • Lifetime Achievement Award, Taiwan Transplantation Society<\/li>\n
          • Distinguished Alumni Achievement Award, National Cheng Kung University<\/li>\n
          • Top 10 Managers, 100 MVP List by Manager Today Magazine<\/em><\/li>\n
          • Special Contribution Award, Medical Dedication Award<\/li>\n
          • Taiwan Medical Model Award<\/li>\n
          • Distinguished Alumni Award, Taipei Medical University<\/li>\n<\/ul>\n
            \n

            Preface<\/strong><\/span><\/h1>\n

            Why Did I Choose to Reopen the Debate on NHI Reform Through \u201cUnnecessary Medical Care\u201d?<\/strong><\/span><\/h2>\n

            As a physician, I have always placed the patient\u2019s best interests first and taken responsibility through my professional expertise. During my service in the National Health Insurance Administration, my guiding principle was to ensure that healthcare professionals received fair compensation while the public enjoyed the genuine social welfare promised by universal health insurance.<\/p>\n

            From holding a scalpel in the operating room to leading national healthcare policy, I always believed that the best systems had already been designed by our public health predecessors. What remained was to make precise corrections and adjustments suited to Taiwan\u2019s reality.<\/p>\n

            Over time, I came to realize that while medical fraud certainly exists and must be addressed, the true force consuming healthcare resources is not illegal fraud. It is the vast amount of unnecessary medical care that is legally reimbursed.<\/p>\n

            These services comply with regulations, pass administrative review, and may even be professionally defensible. Yet under the incentives of the payment system, they are repeatedly expanded, duplicated, and accumulated.<\/p>\n

            This led me to a deeper question:<\/p>\n

            What exactly are we paying for?<\/strong><\/p>\n

            If the system continuously pays for medical services with limited benefit\u2014or no real benefit to patients\u2014then no matter how much we increase the total budget or adjust point values, healthcare professionals will never receive fair returns, and the healthcare system will never truly improve.<\/p>\n

            \n

            Key Arguments in the Book<\/strong><\/span><\/h2>\n

            1. Taiwan\u2019s NHI problem is not simply \u201cinsufficient money\u201d<\/h3>\n

            The real issue is that resources are being spent on services that should not be prioritized, leaving too little for high-value care.<\/p>\n

            2. Unnecessary care is not a moral failure of doctors<\/h3>\n

            Most unnecessary services arise legally and systematically. The problem lies in incentives, not individuals.<\/p>\n

            3. From tiered co-payments to user-pays principles<\/h3>\n

            Reasonable co-payments can help patients and doctors pause and ask an essential question:<\/p>\n

            Is this service truly necessary?<\/strong><\/p>\n

            4. Claims review alone cannot solve the problem<\/h3>\n

            Traditional post-payment audits cannot detect accumulated patterns of low-value care. Reform must combine payment redesign, incentive reform, and AI-driven governance.<\/p>\n

            5. Cooperation between NHI and commercial insurance<\/h3>\n

            Commercial insurers also suffer from the rising costs of unnecessary care. Sustainable reform requires collaboration, data sharing, and aligned incentives.<\/p>\n

            6. Why reform momentum may come from the insurance sector<\/h3>\n

            Both NHI and private insurers bear the cost of waste. When both systems feel pressure, meaningful reform becomes possible.<\/p>\n

            \n

            Conclusion<\/strong><\/span><\/h2>\n

            I did not write this book to criticize anyone.<\/p>\n

            I wrote it to offer Taiwan another possible path for healthcare reform:<\/p>\n

              \n
            • Not blaming doctors<\/li>\n
            • Not morally accusing patients<\/li>\n
            • Not endlessly debating whether funding is enough<\/li>\n<\/ul>\n

              But instead:<\/p>\n

              Recalibrating what the system chooses to pay for.<\/strong><\/p>\n

              If this book leads more people to ask one shared question\u2014<\/p>\n

              What kind of medical care are we actually paying for?<\/strong><\/p>\n

              \u2014then it will have fulfilled my responsibility as a physician and participant in the system.<\/p>\n

              \n

              Core Message<\/strong><\/span><\/h2>\n

              What truly erodes the system is not an insufficient global budget,
              but the continued payment for unnecessary medical care.<\/p>\n

              Healthcare reform is not about how much more money we spend\u2014
              it is about what kind of medical care we are willing to pay for.<\/strong><\/p>\n<\/div>\n

              <\/div>\n
              <\/div>\n
              \n
              \n
              \n
              \n
              \n
              \n
              \n
              \n

              Table of Contents<\/strong><\/span><\/h2>\n

              Author\u2019s Preface<\/h3>\n

              Why Did I Choose to Reopen the Debate on NHI Reform Through \u201cUnnecessary Medical Care\u201d?<\/strong> …… iv<\/p>\n

              Acknowledgments<\/h3>\n

              A Shared Cross-Sector Vision \u2014 To Every Contributor Who Helped Drive Reform<\/strong> …… xiii<\/p>\n

              Foreword<\/h3>\n

              From Division of Roles to Collaboration: Building Long-Term Resilience in Taiwan\u2019s Healthcare Protection System<\/strong>
              Ming-Chung Tsai, Chairman, Fubon Group …… xvii<\/p>\n

              Foreword<\/h3>\n

              Policy Dialogue Through a Media Lens: Debating the Future of National Health Insurance in Liberty Times\u2019 Free Republic<\/strong>
              King-Wen Tsou, Editor-in-Chief, Liberty Times …… xx<\/p>\n

              Foreword<\/h3>\n

              Commitment and Responsibility for Taiwan\u2019s Healthcare Future<\/strong>
              Meng-Ru Shen, President, National Cheng Kung University …… xxv<\/p>\n

              Foreword<\/h3>\n

              Good Intentions Alone Are Not Enough for Governance; Laws Alone Cannot Enforce Themselves<\/strong>
              Ming-Hsien Wu, Dean, National Taiwan University College of Medicine …… xxvii<\/p>\n

              Foreword<\/h3>\n

              Returning to the Essence of Medicine: Seeking a Sustainable and Shared Path to Better Health<\/strong>
              Mai-Szu Wu, President, Taipei Medical University …… xxxii<\/p>\n

              Foreword<\/h3>\n

              A People-Centered Institutional Reflection: Seeking Sustainability Through Fairness and Justice<\/strong>
              Rong-Da Wu, Former Chairman, Consumers\u2019 Foundation, ROC …… xxxiv<\/p>\n

              Foreword<\/h3>\n

              Healing Patients, Healing the System<\/strong>
              Hsing-Fei Lin, Editor-in-Chief, Common Health Magazine …… xxxvii<\/p>\n

              Foreword<\/h3>\n

              A Powerful Alliance Between Public Health and National Health Insurance: Building a Better Healthcare System with Greater Efficiency<\/strong>
              Yi-Hua Chen, Dean, College of Public Health, Taipei Medical University …… xl<\/p>\n

              Foreword<\/h3>\n

              Witnessing the Character of a Life-Saving Physician in Healthcare Reform<\/strong>
              Po-Huang Lee, E-Da Healthcare Group …… xliii<\/p>\n

              \n

              Introduction<\/h2>\n

              National Health Insurance Is Not a Financial Problem, but a Governance Problem<\/strong> …… 1<\/p>\n

              \n

              Part I<\/h1>\n

              How the Payment System Began to Distort<\/h2>\n

              Chapter 1<\/h3>\n

              Taiwan\u2019s Global Budget and Point Value System: Where the Money Comes From and Where It Goes<\/strong> …… 9<\/p>\n

              Chapter 2<\/h3>\n

              The Governance Meaning of Co-payments: Why the User-Pays Principle Must Be Promoted<\/strong> …… 35<\/p>\n

              Chapter 3<\/h3>\n

              The Loss of Healthcare Workforce: How the System Exhausts Professional Talent<\/strong> …… 65<\/p>\n

              Chapter 4<\/h3>\n

              Unnecessary Medical Care: The Problem Is Not Medical Ethics, but Payment Incentives<\/strong> …… 89<\/p>\n

              \n

              Part II<\/h1>\n

              From Claims Boundaries to the Chaos of Medical Devices<\/h2>\n

              Chapter 5<\/h3>\n

              The Boundary Between NHI Claims, Medical Disputes, and Medical Fraud<\/strong> …… 123<\/p>\n

              Chapter 6<\/h3>\n

              Balance Billing for Special Medical Devices, Medical Device Governance, and the Expansion of Self-Paid Care<\/strong> …… 131<\/p>\n

              \n

              Part III<\/h1>\n

              Spillover Effects Between NHI, Commercial Insurance, and Indemnity Plans<\/h2>\n

              Chapter 7<\/h3>\n

              National Health Insurance and Commercial Insurance: Payment Boundaries, Division of Roles, and Collaboration<\/strong> …… 159<\/p>\n

              Chapter 8<\/h3>\n

              How Indemnity Insurance Amplifies Paid Medical Behavior and Drives Rising Loss Ratios<\/strong> …… 187<\/p>\n

              \n

              Part IV<\/h1>\n

              From Legal Accountability to Smart Governance<\/h2>\n

              Chapter 9<\/h3>\n

              Types of Medical Fraud and Legal Liability<\/strong> …… 219<\/p>\n

              Chapter 10<\/h3>\n

              The Breakdown of the NHIA\u2019s Dedicated Enforcement Task Force and the Need for Smart Governance<\/strong>
              Reflections on Article 81 of the National Health Insurance Act Concerning Criminal Referrals …… 259<\/p>\n

              \n

              Conclusion<\/h2>\n

              Unnecessary Medical Care That Gets Paid For Is a Governance Choice<\/strong> …… 277<\/p>\n

              Afterword 1<\/h3>\n

              Who Was This Book Written For?<\/strong> …… 280<\/p>\n

              Afterword 2<\/h3>\n

              The NHIA Personal Data Leak Case? A Reform Episode \u2014 A Painful Moment for NHI!!<\/strong> …… 282<\/p>\n

              Appendix I<\/h3>\n

              Index of the Author\u2019s Major Public Commentaries (Evolution of Ideas)<\/strong> …… 287<\/p>\n

              Appendix II<\/h3>\n

              Key Concepts and Core Terminology of This Book<\/strong> …… 291<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n

              <\/div>\n
              \n
              <\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/section>\n
              <\/div>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

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An Analysis of How the Global Budget of National Health Insurance Leaks into the Explosion of Indemnity Commercial Health Insurance Claims By Director Po-Chang Lee (Published on April 24, 2026) - \u81fa\u5317\u91ab\u5b78\u5927\u5b78\u885b\u751f\u798f\u5229\u653f\u7b56\u7814\u7a76\u4e2d\u5fc3<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/tmuhprc.tmu.edu.tw\/en\/unnecessary-medical-care-that-gets-paid-for-the-invisible-drain-on-healthcare-an-analysis-of-how-the-global-budget-of-national-health-insurance-leaks-into-the-explosion-of-indemnity-commercial-heal\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"\u3010New Book Promotion\u3011Unnecessary Medical Care That Gets Paid For: The Invisible Drain on Healthcare!! 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