{"id":7105,"date":"2026-04-29T14:34:29","date_gmt":"2026-04-29T06:34:29","guid":{"rendered":"https:\/\/tmuhprc.tmu.edu.tw\/?p=7105"},"modified":"2026-04-29T14:37:42","modified_gmt":"2026-04-29T06:37:42","slug":"%e3%80%90media-interview%e3%80%91heho-health-should-national-health-insurance-really-pay-for-what-you-think-is-necessary-care-former-nhia-director-general-po-chang-lees-new","status":"publish","type":"post","link":"https:\/\/tmuhprc.tmu.edu.tw\/en\/%e3%80%90media-interview%e3%80%91heho-health-should-national-health-insurance-really-pay-for-what-you-think-is-necessary-care-former-nhia-director-general-po-chang-lees-new\/","title":{"rendered":"\u3010Media Interview\u3011Heho Health Should National Health Insurance Really Pay for What You Think Is \u201cNecessary Care\u201d? Former NHIA Director-General Po-Chang Lee\u2019s New Book Argues the Real Problem Is Not Insufficient Funds, but Money Spent in the Wrong Direction"},"content":{"rendered":"

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Have you ever wondered during a doctor\u2019s visit: Are all the tests being arranged for you truly necessary?<\/strong><\/p>\n

Taiwan\u2019s National Health Insurance (NHI) system is a source of national pride. With low premiums and easy access to care, many people have come to treat \u201cgoing to the hospital for a check-up\u201d as an almost automatic daily response.<\/p>\n

Yet behind this highly utilized healthcare culture lies a question that has rarely been seriously asked:<\/p>\n

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

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The Problem Is Not a Lack of Money \u2014 It Is Money Spent in the Wrong Places<\/strong><\/span><\/h2>\n

Former Director-General of the National Health Insurance Administration, Po-Chang Lee<\/strong>, wrote this book after leaving office:<\/p>\n

Unnecessary Medical Care That Gets Paid For<\/em><\/strong><\/p>\n

Its central argument is direct\u2014and perhaps uncomfortable:<\/p>\n

Taiwan\u2019s NHI problem has never been merely that \u201cthere is not enough money.\u201d Rather, vast resources are being spent on medical services with limited marginal benefit\u2014or even no substantial benefit to patients.<\/p>\n

The book explains that many of these services comply with regulations, are properly claimed, and follow correct procedures. They are not fraud\u2014but they may not truly be necessary either.<\/p>\n

Under a payment system that rewards \u201cdoing more and earning more,\u201d such services are repeatedly duplicated and expanded. Ultimately, this dilutes reimbursement point values, drives up insurance premiums, and spills over into commercial medical insurance, causing an explosion in indemnity claim payouts.<\/p>\n

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Starting with Lung Nodule Surgery: A Public Health Warning About Overdiagnosis<\/strong><\/span><\/h2>\n

One example in the book is particularly striking.<\/p>\n

In recent years, low-dose CT scans for lung cancer screening have become more common. When small lung nodules are detected, surgery is increasingly performed immediately.<\/p>\n

But is this truly early detection and early treatment<\/strong>\u2014or is it overdiagnosis and overtreatment<\/strong>?<\/p>\n

From a public health perspective, many small nodules would never progress throughout a patient\u2019s lifetime. Yet once discovered, patients often face intense psychological stress, while physicians face the fear of \u201cwhat if we don\u2019t operate?\u201d<\/p>\n

As a result, surgery is performed, both NHI and private insurers are billed, yet whether the patient truly benefits is rarely carefully evaluated.<\/p>\n

This is not the fault of individual physicians.<\/p>\n

It reflects a system that leaves no room to pause and ask:<\/p>\n

Is it worth it? Is it necessary?<\/strong><\/p>\n

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Why Your Medical Decisions Often Lack Cost Awareness<\/strong><\/span><\/h2>\n

Lee argues that one of the key problems is the absence of cost awareness among users.<\/p>\n

Taiwan has long kept co-payments low, meaning patients feel little direct financial impact from seeking care.<\/p>\n

As a result, the mindset becomes:<\/p>\n